What is a bronchoscopy?

A bronchoscopy is a procedure where a doctor looks into your large airways (the trachea and bronchi). These are the main tubes that carry air into the lungs.A fibre-optic bronchoscope is the device usually used. This is a thin, flexible, telescope. The bronchoscope is passed through the nose or mouth, down the back of the throat, into the windpipe (trachea), and down into the bronchi. The fibre-optics allow light to shine around bends in the bronchoscope and so the doctor can see clearly inside your airways.

A rigid bronchoscope is used much less often. It is like a thin, straight telescope. It may be needed for some procedures, and in children. It requires a general anaesthetic.

Both types of bronchoscope have a side channel down which thin instruments can pass. For example, a thin grabbing instrument can pass down to take a small sample (biopsy) from the inside lining of a bronchus.

Who has a bronchoscopy?

To help diagnose a problem

For example, to help make a diagnosis if you have a persistent cough or cough up blood and the cause is not clear. If you have a shadow on a chest X-ray or the doctor can see a growth or a strange-looking area in a bronchus the doctor may take a biopsy (small sample) during a bronchoscopy.

To treat various problems

For example, to remove a small object (such as an inhaled peanut) that has been lodged in an airway, or to insert a small tube called a stent to open a collapsed airway, or to remove a growth that is blocking an airway, etc.

What happens during a bronchoscopy?

Bronchoscopy using a flexible bronchoscope.

This is usually done as an outpatient case. The doctor will numb the inside of your nose and the back of your throat by spraying on some local anaesthetic. Also, you will normally be given a sedative to help you to relax.

You may be connected to a monitor to check your heart rate and blood pressure during the procedure. A device called a pulse oximeter may also be put on a finger. It checks the oxygen content of the blood and will indicate if you need extra oxygen during the bronchoscopy. You may have a soft plastic tube placed just inside your nostril to give you oxygen during the procedure.

The doctor will insert the tip of the bronchoscope into a nostril and then gently guide it round the back of your throat into your trachea (windpipe). The doctor looks down the bronchoscope and inspects the lining of the trachea and main bronchi (the main airways). Also, modern bronchoscopes transmit pictures through a camera attachment on to a TV monitor for the doctor to look at.

Sometimes bronchial lavage is done where some fluid is squirted into a section of the lung and then syringed back. The fluid is then examined in the laboratory to look for abnormal cells and other particles that may be present in certain diseases.

The bronchoscopy itself usually takes about 20-30 minutes.

Bronchoscopy using a rigid bronchoscopy

This requires a general anaesthetic, similar to that for minor operations

What preparation do I need to do?

  • You will usually have a blood test done shortly before the bronchoscopy to check how well your blood will clot.
  • That you should not eat or drink for several hours hours before the bronchoscopy. (Small sips of water may be allowed up to two hours before the test.)
  • That you will need somebody to accompany you home, as you will be drowsy with the sedative.

What can I expect after a flexible bronchoscopy?

You should not drive, operate machinery or drink alcohol for 24 hours after having the sedative. You should not eat or drink anything for two hours after the bronchoscopy because your throat will still be numb. You will need somebody to accompany you home and to stay with you for 24 hours until the effects have fully worn off.

Are there any side-effects or possible complications?

Most are done without any problem. Your nose and throat may be a little sore for a day or so afterwards. You may feel tired or sleepy for several hours, caused by the sedative. There is a slightly increased risk of developing a throat or chest infection following a bronchoscopy.If you had a biopsy taken, you may cough up a little blood a few times in the following day or so. Rarely, a bronchoscopy can cause damage to the lung. Serious complications from a bronchoscopy are rare.

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