Pulmonology | by Dr. Raja Dhar | Published on 03/08/2020
Bronchoscopy is a medical procedure used to examine the airways in the lungs. This procedure involves inserting a flexible tube called a bronchoscope into the patient's mouth or nose and passing it down into the trachea (windpipe) and bronchi (the large airways in the lungs). The bronchoscope is fitted with a light and a camera, allowing doctors to view the airways in real-time on a monitor.
Bronchoscopy is used to diagnose and treat a range of lung conditions, including infections, tumors, inflammation, and bleeding. Here is a closer look at the procedure and its uses. This blog contains information about bronchoscopy and when it is recommended. However, please note that this blog does not replace the significance of a doctor’s consultation.
Doctors classify bronchoscopy into two main types - Flexible and Rigid.
Bronchoscopy is used for both diagnostic and therapeutic purposes. Here are some of the most common uses of the procedure:
Preparing for a bronchoscopy usually involves food and medication restrictions for a specified period. Your doctor will inform you about the necessary precautions you should take owing to your current medication use. You have to avoid foods and drinks for at least 6-12 hours before the bronchoscopy procedure. Your doctor will also advise you against certain medications like:
You will likely be given sedative medicines via IVs or a local anesthetic spray to help you relax. Make sure to arrange a ride or someone to take you back home after the procedure. Because of the sedatives as you will be unable to drive.
Before the procedure, doctors spray a numbing drug or sedative into the mouth or throat. But if the bronchoscope is inserted through the nose, a numbing jelly is placed in the nostrils. Many people are given anesthesia to help them relax.
Once people start to relax from sedatives, doctors gently insert the bronchoscope into the bronchi. This usually makes people cough at first but subsides as the numbing drug takes effect. As doctors move the bronchoscope around, you can feel a tugging or pressing sensation.
The next part of the procedure is called a lavage or bronchial washing. Doctors send a saline solution through the tube to wash the lungs. Lavage is also used to collect samples of lung cells, microbes, fluids, and other substances inside the air sacs. These samples are examined later under a microscope.
Additionally, tiny brushes, needles, or forceps are sometimes passed through the bronchoscope to take small tissue samples (biopsies) from the lungs. Doctors can also insert a stent in your airways and perform an ultrasound. This helps doctors to have a clearer view of the lymph nodes and tissues around the airways.
Once the procedure finishes, doctors remove the bronchoscope. A bronchoscopy typically lasts about 30-60 minutes based on your lung condition and the number of examinations. And people can return home on the same day.
Recovery from bronchoscopy is fairly fast. You have to stay at the hospital for a couple of hours and let the sedative wear off once the procedure is over. Doctors usually monitor your breathing and blood pressure during recovery time. The numbness in your throat will subside within two hours. Following this, you can safely consume any food and drink. However, your throat will be sore for a couple of days.
Bronchoscopy is usually safe for most people. Nonetheless, there are certain risks involved, although uncommon and minor. Complications may arise because of the sedative used or the procedure itself. Risks of bronchoscopy may include the following -
In rare cases, bronchoscopy can also cause a heart attack or lung collapse which is known as pneumothorax resulting in a life-threatening situation. The chances of pneumothorax are usually increased when doctors use a rigid bronchoscope to perform the procedure. There may be additional risks from anesthesia such as -
Bronchoscopy is a valuable tool for diagnosing and treating a range of lung conditions. If you are scheduled to have a bronchoscopy, be sure to discuss the risks and benefits of the procedure with your doctor beforehand. With proper preparation and care, a bronchoscopy can provide important information about your lung health and help guide your treatment plan.
Bronchoscopy is not a painful test. However, you may feel a bit uncomfortable during the procedure. The doctor makes sure to not hurt you and makes you feel as comfortable as possible.
Yes, bronchoscopy is a reliable test to detect pulmonary tuberculosis. Discuss your symptoms with the doctor for an early diagnosis and effective treatment.
Flexible fiberoptic bronchoscopy (FFB) is a minimally invasive procedure that allows the surgeon to directly visualize the upper and lower airways using a light source, fiber optics, and a camera.
While there are still debates on the accuracy of bronchoscopy being able to detect cancer, it can detect suspicion of cancer in several chronic smokers. However, the procedure may miss 40% to 50% of lung cancers.
On average, bronchoscopy usually takes about 30 minutes. However, it can vary depending on the severity of the condition, the medical health of the individual, and the extent of the test.
No, a bronchoscopy exam requires an empty stomach which means you cannot eat or drink 6-8 hours before the procedure. Talk to your doctor about how you can prepare for the procedure to avoid any complications.