Bronchoskopy

Bronchoscopy is a procedure that allows visualization of the airways from the trachea into the bronchi using a bronchoscope. It can be diagnostic, to examine airways and obtain samples, or therapeutic, to treat problems such as bleeding, obstruction, or infection. The procedure is performed by a pulmonologist or thoracic surgeon and may be done under local anesthesia with sedation or general anesthesia.

There are two main types: flexible bronchoscopy, which uses a fiberoptic or video bronchoscope and is common; and rigid bronchoscopy, which uses a hollow metal tube and is less common but useful for large foreign bodies or heavy bleeding.

Before the procedure, patients are assessed for anesthesia risk, allergies, and airway status, and informed consent is obtained. The airway is usually accessed through the nose or mouth, depending on anatomy and patient tolerance. Topical anesthetics and sedation are used to minimize discomfort; supplemental oxygen is often provided.

During bronchoscopy, the operator visualizes the airway and can collect samples such as biopsies, brushings, and washing or lavage to diagnose infections or malignancy. Therapeutic uses include removing mucus plugs, retrieving aspirated foreign bodies, dilating narrow airways, placing devices, and stopping airway bleeding.

Common risks include bleeding, infection, pneumothorax, bronchospasm, low oxygen levels, and adverse reactions to anesthesia. Absolute contraindications include significant uncorrected coagulopathy or severe hemodynamic instability; relative contraindications include poor lung function or high risk from sedation. Complications are generally rare and most are manageable.

After the procedure, patients are monitored until awake and stable. A chest X-ray may be obtained if there is concern for pneumothorax or other complications. Most recover fully with minimal downtime, and activity can resume as advised by the care team.

Bronchoscopy requires specialized training and is performed in hospitals or approved clinics with appropriate monitoring and equipment.