Bronchoscopy is a minimally invasive diagnostic and therapeutic procedure that is done for the evaluation and management of diseases of the lungs and the airways. The procedure is performed by pulmonologists using an endoscopic instrument called a bronchoscope that helps to visualize the insides of the lungs and the airways with the help of fibre optics and video equipment, and with the use of additional instruments to collect tissue samples or remove foreign bodies.
Bronchoscopy is done as an elective procedure, but in certain circumstances may also be done as an emergency procedure.
Bronchoscopy may be of the following types:
Some indications for Bronchoscopy include:
Bronchoscopy is not done under the following circumstances:
Some investigations that may be advised before performing a Bronchoscopy include:
Before performing a Bronchoscopy the following are done:
Anesthesia: The procedure is performed under conscious sedation and local anesthesia.
Duration: Bronchoscopy can last between 3-5 hours depending on the procedure being performed.
After the administration of sedation and local anesthetic, with the individual in either a seated or lying down position, the lubricated bronchoscope is introduced either through the nose or mouth, down the throat, through the vocal cords, and into the trachea (windpipe) and finally into the bronchi. Several other procedures such as bronchial washing with saline, bronchial brushing to obtain suspicious cells, bronchoalveolar lavage with saline to retrieve cells proteins, or microorganisms at the alveolar level, transbronchial biopsy using forceps to retrieve lung tissue, and transbronchial needle aspiration using a retractable needle to obtain samples from lymph nodes and mediastinal masses may also be done as required.
After the procedure is complete, the instrument is slowly withdrawn along the same path.
After Bronchoscopy, the individual is placed under observation and monitored for a few hours. The following are done:
Common post-procedure complaints:
Discharge: If recovery is complete and no complications are present, the individual is discharged on the next day after the procedure.
Review: As advised by the attending specialist.
Some measures that need to be taken after a Bronchoscopy include:
Some complications associated with Bronchoscopy include:
Bronchoscopy is a relatively safe procedure, and complications are usually minimal.
It is advisable to seek medical attention if there is persistent fever, an increase in chest pain, difficulty breathing, coughing up of more than 15 – 20 ml of blood.