It is always useful to remember the past in order to understand and appreciate the present. In the past decades, we have experienced extraordinary changes and innovations in our discipline: interventional pulmonology. Almost all aspects of this sub-specialty have been transformed. Diagnostic bronchoscopy, previously limited to central airways, can now assess the periphery of the lungs thanks to new smaller bronchoscopes and innovative guiding techniques (virtual bronchoscopy, electromagnetic navigation, radial ultrasound, cone-bean computed tomography (CT)), allowing us to reach previously inaccessible nodules [1]. Mediastinal and hilar nodes are now routinely sampled using endobronchial ultrasound guidance, replacing surgical staging as the initial procedure of choice in many institutions [2]. Diseases which were previously almost considered as contraindications to bronchoscopy, such as asthma and COPD/ emphysema, can now, in selected cases, be treated endoscopically [3]. Therapeutic bronchoscopy for central airway diseases remains the realm of rigid bronchoscopy and airway stenting. Stenting is at the edge of a new era with customised/3-dimensional printed, biodegradable and bioactive stents [4]. Therapeutic bronchoscopy for peripheral and inoperable early stage lung cancer is one of the most promising areas for research and clinical applications, which could eventually compete one day with surgical resection or stereotactic radioablative therapy [5]. The minimally invasive diagnostic and therapeutic approach to pleural disease has also been fascinating. Ultrasound-guided pleural interventions, small-bore chest tubes, mini-thoracoscopy and indwelling pleural catheters have drastically changed the way we care for patients [6]. Training has shifted from the “see one, do one, teach one” directly on patients to more structured programmes in which simulation is an integral part of the educational experience [7]. Scientific publications in interventional pulmonology have moved from case reports, expert opinions and monocentric retrospective studies to randomised, prospective and multicentric trials [8, 9]. All the different topics listed above will be addressed in detail in the articles in the forthcoming new “Interventional pulmonology” series in the European Respiratory Review. The first of which, by DEMAIO and STERMAN [10], is published in the current issue.
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