What is Bronchoscopy?
Bronchoscopy is an endoscopic procedure to allow the doctor to view the airways, larynx and lungs to diagnose certain respiratory conditions. It is done with an instrument called a bronchoscope and can also be used to treat some lung conditions. The scope is usually inserted via the nose. While a bronchoscope can be flexible or rigid, a flexible bronchoscope is more commonly used. This is because the flexible bronchoscope usually does not require general anaesthesia, is more comfortable for the patient, and allows for a better view of the smaller airways.
Why is Bronchoscopy Performed?
Common reasons to perform a bronchoscopy for diagnosis include:
- Suspected lung cancer
- Suspected interstitial lung disease
- Coughing up blood (hemoptysis)
- Possible foreign object in the airway
- Prolonged cough
- Certain infections of the lungs and bronchi eg tuberculosis
- Inhaled toxic gas or chemical
- To diagnose a lung rejection after a lung transplant
Common reasons to perform a bronchoscopy for treatment include:
- Remove fluid or mucus from the airways
- Remove a blockage or foreign object from the airways
- Widen an airway that is blocked or narrowed with the use of stents
- Facilitate the use of a laser
Flexible Bronchoscopy
The flexible bronchoscope is a lighted tube less than 6 mm diameter and about 1 meter long. It has a camera at the tip and allows one to look at the larynx, breathing tubes and post nasal space. Still photos and video recordings can be made throughout the procedure. This procedure is usually done under local anaesthesia, which is administered.by a spray or a gel. If a biopsy is anticipated, usually some pre-medications or sedation may be given as the procedure is longer. Inserting the bronchoscope may make the patient cough at first but is generally tolerated by most. The procedure lasts between 10 minutes to 40 minutes, depending on what type of specimens are obtained eg biopsy or lavage.
Rigid Bronchoscopy
A rigid bronchoscope is a hollow tube with a camera at the tip. This is usually performed under general anaesthesia in the operating room. Rigid bronchoscopy is usually performed for therapeutic (treatment) reasons in the following scenarios::
- bleeding in the airway that could block the flexible scope’s view.
- removing large tissue samples for biopsy.
- clearing the airway of objects such as a piece of food and foreign objects that cannot be removed using a flexible bronchoscope.
- unblocking a major airway via the use of lasers or stents
