Catherine Spader, RN
What is a bronchoscopy?
A bronchoscopy is a minimally invasive procedure used to diagnose and treat respiratory conditions. Bronchoscopy involves inserting a bronchoscope through your mouth or nose and passing it into your airways and lungs. A bronchoscope is a lighted, tube-like instrument with a camera for examining the inside of your airways.
Bronchoscopy is only one method of diagnosing and treating lung-related diseases. Discuss all your options with your doctor to understand which choices are best for you.
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Types of bronchoscopy
The types of bronchoscopy procedures include:
Flexible bronchoscopy involves passing a thin, flexible bronchoscope through your nose or mouth, down your throat, and into your airways. The bronchoscope has a light and small camera that allows your doctor to see and take pictures of your windpipe and airways.
Rigid bronchoscopy involves passing a wider and stiffer bronchoscope through the mouth. This larger bronchoscope can accommodate special instruments used for treatments. Treatments include removing a foreign body, inserting special ultrasound equipment, treating bleeding, and placing stents to keep the airway open.
Why is a bronchoscopy performed?
Your doctor may recommend a bronchoscopy to diagnose and treat certain conditions of the trachea (windpipe), bronchi, and lungs.
A diagnostic bronchoscopy allows your doctor to examine the lungs and airways and take a biopsy. A biopsy involves removing tissue samples to test for cancer and other diseases. A diagnostic bronchoscopy can help diagnose the cause of the following conditions and situations:
Abnormal findings on a chest X-ray or CT
Atelectasis (lung collapse)
Cancer or tumors including lung or tracheal cancer
Chronic cough lasting several weeks
Interstitial lung disease (inflammation of deep lung tissues)
Lung bleeding including coughing up blood
Swelling or injury of the vocal cords, trachea (windpipe), or other airways
A therapeutic bronchoscopy provides treatments. It allows your doctor to:
Insert an endotracheal tube into the trachea to permit mechanical ventilation
Place medication directly on a lung problem
Place a small tube or stent to hold the airway open
Remove a foreign object
Remove all or part of a tumor
Suction excessive secretions in the deep airways in the lungs
Who performs a bronchoscopy?
Pulmonologists and thoracic surgeons perform outpatient bronchoscopies.
Pulmonologists are internists or pediatricians with specialized training in treating diseases and conditions of the chest, such as pneumonia, asthma, tuberculosis, emphysema, or complicated chest infections. Thoracic surgeons specialize in surgical treatment of diseases of the chest, including the blood vessels, heart, lungs and esophagus.
How is a bronchoscopy performed?
Your bronchoscopy will be performed in a special bronchoscopy room or lab in a clinic or hospital. It is also performed in surgery and in the intensive care unit (ICU) for in seriously ill patients.
The procedure takes about four hours, including preparation and recovery time. It generally involves these steps:
You will undress and put on a patient gown. Your care team will provide sheets or blankets for modesty or warmth.
Your care team will position you on a special table or bed and start an intravenous (IV) line.
- You will receive anesthesia and medication to make you comfortable during the procedure. For flexible bronchoscopy, this is generally a local anesthetic, such as lidocaine spray, to numb your mouth and throat. You will also have oral or IV sedation to make you relaxed and sleepy. For rigid bronchoscopy, you will likely have general anesthesia to make you completely unaware of the procedure.
Your doctor will insert the bronchoscope through your nose or mouth and pass it down your throat into your trachea (windpipe) and lungs.
Your doctor will take pictures of your airways. Your doctor might insert tiny instruments through the bronchoscope to take a biopsy and perform a treatment. Treatments include removal of a tumor or foreign object and washing out the lungs with a special saline solution.
Your doctor will remove the bronchoscope.
Your care team may take a chest X-ray to check for lung problems or damage due to the procedure.
Will I feel pain?
Your comfort and relaxation is important to you and your care team. You will be unaware and not feel any pain during your bronchoscopy if you have general anesthesia.
If you have local anesthesia and sedation, you may gag a little as the bronchoscope passes through the back of your mouth. Once it enters your throat, that feeling should go away. Tell your doctor if any discomfort does not pass quickly.
You may feel hoarse and have a sore throat after bronchoscopy. You doctor will treat your pain or discomfort. Tell your doctor or care team if treatments are not helping or your discomfort is getting worse because it may be a sign of a complication.
What are the risks and potential complications of a bronchoscopy?
A bronchoscopy is generally safe, with minor side effects and a low risk of complications. Side effects include feeling hoarse and having a sore throat after the procedure. These are temporary and should improve in a day or two.
Bronchoscopy does involve some risks and possible complications. Complications may become serious in rare cases. Complications can develop during the procedure or recovery.
Potential complications of bronchoscopy
Complications of bronchoscopy include:
Adverse reaction or problems related to anesthesia, sedation or medications, such as an allergic reaction and problems with breathing
Pneumothorax (collapsed lung)
Reducing your risk of complications
You can reduce the risk of some complications by following your treatment plan and:
Following activity, dietary and lifestyle restrictions and recommendations before your procedure and during your recovery
Notifying your doctor right away of any concerns, such as ongoing sore throat and hoarseness, coughing up blood, fever, or increase in pain
Taking or stopping your medications exactly as directed
Telling all members of your care team if you have any allergies
How do I prepare for my bronchoscopy?
You are an important member of your own healthcare team. The steps you take before procedure bronchoscopy can improve your comfort and outcome and help get the most accurate test results.
You can prepare for a bronchoscopy by:
Answering all questions about your medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.
Completely following all preoperative instructions. This generally includes not eating or drinking anything for six to 12 hours before the procedure.
Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.
Questions to ask your doctor
Having a bronchoscopy can be stressful. It is common for patients to forget to ask questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before a bronchoscopy and between appointments.
It is also a good idea to bring a list of questions to your appointments. Common questions include:
Why do I need a bronchoscopy? Are there any other options for diagnosing or treating my condition?
How long will the procedure take? When can I go home?
What restrictions will I have after the procedure? When can I return to work and other activities?
What kind of assistance will I need at home? Will I need a ride home?
How should I take my medications?
How will you treat my discomfort?
When and how will I get my test results?
When should I follow up with you?
How should I contact you? Ask for numbers to call during and after regular hours.
What can I expect after my bronchoscopy?
Knowing what to expect after a bronchoscopy can help you get back to your everyday life as soon as possible.
How will I feel after the bronchoscopy?
You may have a temporary sore throat or hoarse voice after bronchoscopy. Your doctor will treat your discomfort or pain so you stay comfortable. Tell your doctor or care team right away if your pain or discomfort gets worse or if it returns after treatment. This could be a sign of a complication. Prompt treatment of pain is also the best way to control it effectively.
You might feel drowsy for the next 24 hours if you had a sedative or general anesthesia. You may also have some nausea. Tell your doctor if you are nauseated so it can be treated.
When can I go home?
You will stay in the recovery room after surgery until you are alert, breathing effectively, and your vital signs are stable. You will go home when the major effects of anesthesia have worn off and you are breathing and swallowing effectively. This generally takes about an hour or two. Some patients go home on the same day. Seriously ill patients stay in the hospital for further observation and treatment.
You may have a sore throat from the procedure. This is usually temporary, but tell your care team if you are uncomfortable.
You will not be able to drive for 24 hours and you will need a ride home because you will still be drowsy. Someone should stay with you for the first day or so. Your doctor will tell you when you can return to normal activities.
When should I call my doctor?
It is important to keep your follow-up appointments after bronchoscopy. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:
Breathing problems such as shortness of breath, difficulty breathing, labored breathing, or wheezing
Cough that does not go away or you are coughing up blood
Fever. Follow your doctor's specific instructions about when to call for a fever.
Inability to urinate or have a bowel movement
Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot
Pain that is not controlled by your pain medication
Sore throat or hoarseness that lasts longer than expected
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