Bronchoscopy

Revising Medical Author: George Schiffman, MD
Revising Medical Editor: Melissa Conrad Stöppler, MD

• What is bronchoscopy?
• What are the indications for bronchoscopy?
• What are the potential complications of bronchoscopy?
• How does a patient prepare for bronchoscopy?
• What should a patient expect during bronchoscopy?
• What can a patient expect after a bronchoscopy?
• What's new in bronchoscopy?
• Bronchoscopy At A Glance

What is bronchoscopy?

Bronchoscopy is a procedure during which an examiner uses a viewing tube to evaluate a patient's lung and airways including the voice box and vocal cord, trachea, and many branches of bronchi. Bronchoscopy is usually performed by a pulmonologist or a thoracic surgeon. Although a bronchoscope does not allow for direct viewing and inspection of the lung tissue itself, samples of the lung tissue can be biopsied through the bronchoscope for examination in the laboratory.

There are two types of bronchoscopes - a flexible fiberoptic bronchoscope and a rigid bronchoscope. Since the 1960s, the fiberoptic bronchoscope has progressively supplanted the rigid bronchoscope because of overall ease of use. In some patients, flexible fiberoptic bronchoscopy can be performed without anesthesia, but in most cases, conscious sedation "twilight sleep") is utilized. However, rigid bronchoscopy requires general anesthesia and the services of an anesthesiologist. During the bronchoscopy, the examiner can see the tissues of the airways either directly by looking through the instrument or by viewing on a TV monitor.

Depending on the indication the examiner will choose between the flexible fiber optic bronchoscope or the rigid bronchoscope. For example, if a patient were coughing up large amounts of blood, a rigid bronchoscope is used since it has a large suction channel and allows for the use of instruments that can better control bleeding. The vast majority of bronchoscopies are performed using the flexible fiberoptic scope because of the improved patient comfort and reduced use of anesthesia.

What are the indications for bronchoscopy?

Bronchoscopy can be used for diagnosis or treatment. (The lists below are not meant to be all-inclusive, but are intended to provide a greater awareness and knowledge regarding the indications for bronchoscopy.)

Bronchoscopy is used to make a diagnosis most commonly for these conditions:

1. persistent or unexplained cough;

2. blood in the sputum (coughed up mucus material from the lungs);

3. abnormal chest x-ray such as a mass, nodule, or inflammation in the lung; or

4. evaluation of a possible lung infection.

Bronchoscopy is used for treatment:

1. to remove foreign bodies in the airway;

2. to place a stent (a tiny tube) to open a collapsed airway due to pressure by a mass or tumor; or

3. to remove a mass or growth that is blocking the airway.

Next: What are the potential complications of bronchoscopy? »

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