Bronchoscopy

What is bronchoscopy?

Bronchoscopy is a type of endoscopy, where a thin tube with a light and a camera on it's tip (along with other medical instruments if needed) is inserted into the lungs via the mouth or the nose. It allows the doctor to examine the airways of the lungs to be able to diagnose or confirm a condition. In some instances certain minor procedures can be carried out using medical instruments on the bronchoscope.

Why might I need a bronchoscopy?

Bronchoscopy is recommended in the following circumstances...

  • To examine the airways for possible causes of symptoms such as wheezing, chronic cough, coughing up blood or shortness of breath. Tissue samples (biopsies) can be taken to be examined for the presence of infection or cancer
  • To evaluate repeated episodes of a collapsed lung (medical term - atelectasis) - a bronchoscopy will show if this is caused by an obstruction, which may be caused by a mucus build up, a foreign object or a tumour. The doctor may remove any obstruction found during the procedure and/or take a tissue sample. Small tubes called 'stents' may also be inserted to keep affected sections of airways open.
  • To investigate abnormalities showing up on x-rays or CT scans. Generally tissue samples are taken to review for the presence of infection, inflammation or cancer

What is involved in a bronchoscopy?

A bronchoscopy is normally performed under mild sedation, so you stay awake but in a relaxed and drowsy state during the procedure. Instruments are attached to monitor your blood pressure, heart activity and blood oxygen level. A small amount of local anaesthetic is sprayed at the back of the throat and the bronchoscope is slowly fed in through the nose or the mouth.

Images from the camera on the end are displayed on a colour monitor. The bronchoscope is passed down the throat and through the vocal cords and into the airways of the lungs.
As the bronchoscope is making its way down to the airways it is not uncommon to feel the need to cough or to take a breath. In this case more anaesthetic can be given. When the bronchoscope passes through the vocal cords it becomes difficult to speak normally but you will be able to breathe normally. When the bronchoscope is removed everything will return to normal. Oxygen levels are monitored at all times to ensure you are getting enough air into the lungs. The whole procedure generally takes no more than 25 minutes.

How should I prepare for a bronchoscopy?

You will need to have a blood test before the procedure to make sure your blood is clotting properly. You may be asked to stop any blood thinning medication 3-4 days before the procedure. You must inform your doctor if you have had any previous allergic reactions or complications during medical or dental procedures. You should not eat or drink anything in the eight hours immediately before the procedure and you should remove any dentures or other orthodontics from the mouth beforehand.

What happens after the procedure?

You will stay in the hospital for a short while for monitoring and until the sedative wears off. As you have been sedated it is important to have someone else take you home. After the procedure you may have a slight sore throat and /or some hoarseness or a cough, all of which are normal.

If you have chest pain that gets worse or you are short of breath or if you cough up more than two tablespoons of blood you should seek immediate medical attention. You may suffer a temperature after the procedure. Again this is normal, however if it last more than a few days or exceeds 38C call your doctor or specialist.

Your doctor will be able to give you a summary of the findings of the bronchoscopy on the spot, although test results from tissue samples will take longer to come back.

What are the risks of bronchoscopy?

Bronchoscopy is a very safe procedure with complications reported in 1.3% of procedures, with the majority of these being minor complications. Your doctor will be able to advise you of specific risks relating to your procedure.