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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,
trachea, and lower airways.
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
Special procedures, such as widening (dilating) the airway
or destroying a growth using a
laser, are usually done with a rigid
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 procedure information formmedical procedure 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
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.
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.
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.
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.
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
Finally, small biopsy forceps may be used to remove a
sample of lung tissue. This is called a transbronchial biopsy.
This procedure is usually
general anesthesia. You will lie on your back on a
table with your shoulders and neck supported by a pillow.
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.
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
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
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.
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.
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
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
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
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
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 (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis:
Fischbach FT, Dunning MB III, eds. (2009).
Manual of Laboratory and Diagnostic Tests, 8th ed.
Philadelphia: Lippincott Williams and Wilkins.
Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby.
October 24, 2012
Adam Husney, MD - Family Medicine & Robert L. Cowie, MB, FCP(SA), MD, MSc, MFOM - Pulmonology
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