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Bronchoscopy is a procedure that allows your doctor to look at your airway through a thin viewing instrument called a bronchoscope. During a bronchoscopy, your doctor will examine your throat, larynx, trachea, and lower airways.
Bronchoscopy may be done to diagnose problems with the airway, the lungs, or with the lymph nodes in the chest, or to treat problems such as an object or growth in the airway.
There are two types of bronchoscopy.
Special procedures, such as widening (dilating) the airway or destroying a growth using a laser, are usually done with a rigid bronchoscope.
Bronchoscopy may be used to:
You will be asked to sign a consent form that says you understand the risks of the test and agree to have it done.
Talk to your doctor about any concerns you have regarding the need for the procedure, its risks, how it will be done, or what the results will mean. To help you understand the importance of this procedure, fill out the medical test information form( What is a PDF document? ).
Before you have a bronchoscopy, tell your doctor if you:
Your doctor will tell you how soon before the biopsy to stop eating and drinking. Follow the instructions exactly about when to stop eating and drinking, or your test may be canceled. If your doctor has instructed you to take your medicines on the day of surgery, please do so using only a sip of water.
Your doctor may order other tests before your bronchoscopy, such as a complete blood count (CBC), clotting factors, arterial blood gas (ABG), or lung function tests.
Arrange to have someone drive you home after the procedure.
You may be asked to remove dentures, eyeglasses or contact lenses, hearing aids, wigs, makeup, and jewelry before the bronchoscopy procedure. You will empty your bladder before the procedure. You will need to take off all or most of your clothes (you may be allowed to keep on your underwear if it does not interfere with the procedure). You will be given a cloth or paper covering to use during the procedure.
The procedure is done by a thoracic surgeon or a pulmonologist and an assistant. Your heart rate, blood pressure, and oxygen level will be checked during the procedure.
A chest X-ray may be done before and after the bronchoscopy.
During this procedure, you will lie on your back on a table with your shoulders and neck supported by a pillow, or you will recline in a chair that resembles a dentist's chair. Sometimes the procedure is done while you are sitting upright.
You will be given a sedative to help you relax. You may have an intravenous line (IV) placed in a vein. You will remain awake but sleepy during the procedure.
Before the procedure, your doctor usually sprays a local anesthetic into your nose and mouth. This numbs your throat and reduces your gag reflex during the procedure. If the bronchoscope is to be inserted through your nose, your doctor may also place an anesthetic ointment in your nose to numb your nasal passages.
Your doctor gently and slowly inserts the thin bronchoscope through your mouth (or nose) and advances it to the vocal cords. Then more anesthetic is sprayed through the bronchoscope to numb the vocal cords. You may be asked to take a deep breath so the scope can pass your vocal cords. It is important to avoid trying to talk while the bronchoscope is in your airway.
An X-ray machine (fluoroscope) may be placed above you to provide a picture that helps your doctor see any devices, such as forceps to collect a biopsy sample, that are being moved into your lung. The bronchoscope is then moved down your larger breathing tubes (bronchi) to examine the lower airways.
If your doctor collects sputum or tissue samples for biopsy, a tiny biopsy tool or brush will be used through the scope. A salt (saline) fluid may be used to wash your airway, then the samples are collected and sent to the lab to be studied.
Finally, small biopsy forceps may be used to remove a sample of lung tissue. This is called a transbronchial biopsy.
This procedure is usually performed under general anesthesia. You will lie on your back on a table with your shoulders and neck supported by a pillow.
You will be given a sedative to help you relax. You will have an intravenous line (IV) placed in a vein. Once you are asleep, your head will be carefully positioned with your neck extended. A tube (endotracheal) will be placed in your windpipe (trachea) and a machine will help you breathe. Your doctor then slowly and gently inserts the bronchoscope through your mouth and into your windpipe.
If your doctor collects sputum or tissue samples for biopsy, a tiny biopsy tool or a brush will be inserted through the scope. A salt (saline) fluid may be used to wash your airway, then the samples are collected and sent to the lab for biopsy.
Recovery after bronchoscopy
Bronchoscopy by either procedure usually takes about 30 to 60 minutes. You will be in recovery for 1 to 3 hours after the procedure. Following the procedure:
If you have general anesthesia, you will feel nothing during the procedure. Oxygen is usually given through a small tube placed in your nose if you are awake during the procedure.
You may be able to feel pressure in your airway as the bronchoscope is moved from place to place. You may gag or cough during bronchoscopy. Your airway will not be blocked, but if you feel discomfort let your doctor know.
After the procedure, you may feel tired for a day or so and have general muscle aches. If a local anesthetic is used, you may have a bitter taste in your mouth. Your mouth may feel very dry for several hours after the procedure. You may also have a sore throat and some hoarseness for a few days. Sucking on throat lozenges or gargling with warm salt water may help soothe your sore throat.
The anesthesia will make it hard to swallow. You will need to avoid eating or drinking for 1 to 2 hours after the procedure.
If a biopsy sample was taken, it is normal to spit up a small amount of blood after the procedure.
Bronchoscopy is generally a safe procedure. Although complications are rare, your doctor will discuss any risks with you. Complications that may occur include:
If a biopsy was done during bronchoscopy, complications that may occur include:
Call your doctor immediately if you:
Bronchoscopy is a procedure that allows your doctor to look at your airway through a thin viewing instrument called a bronchoscope. Your doctor may discuss your results with you soon after the procedure. Test results on any biopsy samples are usually available in 2 to 4 days.
The large airway leading to the lungs and the breathing tubes in the lungs appear normal. There are no objects, thick secretions, or growths.
An object, thick secretions, or growths are blocking your airway.
Tissue sample shows a lung infection or disease, such as tuberculosis or lung cancer.
Reasons you may not be able to have the test or why the results may not be helpful include:
Also, a biopsy collects tissue from such a small area, so there is a chance that a cancer may be missed.
Other Works Consulted
Chernecky CC, Berger BJ (2013). Laboratory Tests and Diagnostic Procedures, 6th ed. St. Louis: Saunders.
Fischbach F, Dunning MB III (2015). A Manual of Laboratory and Diagnostic Tests, 9th ed. Philadelphia: Wolters Kluwer Health.
Pagana KD, Pagana TJ (2014). Mosby's Manual of Diagnostic and Laboratory Tests, 5th ed. St. Louis: Mosby.
Current as ofSeptember 5, 2018
Author: Healthwise StaffMedical Review: Adam Husney, MD - Family MedicineE. Gregory Thompson, MD - Internal MedicineDavid C. Stuesse, MD - Cardiac and Thoracic Surgery
Current as of:
September 5, 2018
Medical Review:Adam Husney, MD - Family Medicine & E. Gregory Thompson, MD - Internal Medicine & David C. Stuesse, MD - Cardiac and Thoracic Surgery
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