03/06/2025
# Patient Guide to Bronchoscopy: What You Need to Know
Bronchoscopy is a common medical procedure that allows doctors to examine your airways and lungs.
# # What is Bronchoscopy?
Bronchoscopy is a minimally invasive procedure that enables doctors to look inside your lungs and airways using a bronchoscope - a thin, flexible tube with a light and camera at its tip . The bronchoscope is typically about as thin as a pencil and can be gently guided through your nose or mouth, down your throat, and into your lungs .
There are two main types of bronchoscopes:
- **Flexible bronchoscope**: Most commonly used; it's bendable and about 2 feet (60 cm) long and less than half an inch (1.27 cm) wide
- **Rigid bronchoscope**: Used less often, primarily for specific therapeutic procedures or in children; requires general anesthesia
The procedure is usually performed by a pulmonologist (lung specialist) and typically takes 30-60 minutes, though you should plan for several hours including preparation and recovery time .
# # Why is Bronchoscopy Performed?
Doctors recommend bronchoscopy for both diagnostic and therapeutic purposes:
# # # Diagnostic Uses:
- Investigating persistent cough or coughing up blood (hemoptysis)
- Evaluating abnormal findings on chest X-rays or CT scans
- Identifying lung infections or inflammation
- Taking tissue samples (biopsies) to diagnose lung diseases or cancer
- Assessing lymph nodes near the lungs
- Evaluating shortness of breath or low oxygen levels
- Checking for lung rejection after transplant
# # # Therapeutic Uses:
- Removing foreign objects from airways
- Clearing mucus plugs or fluid from airways
- Placing stents to keep narrowed airways open
- Treating tumors or bleeding in the airways
- Performing lung lavage (washing) for certain conditions
Recent advances include robotically-assisted bronchoscopy, which can help reach small, peripheral lung nodules with high success rates (98.7% in recent studies) .
# # How to Prepare for Bronchoscopy
Proper preparation helps ensure a safe and successful procedure:
1. **Fasting**: You'll need to avoid eating or drinking for 6 hours before the procedure (small sips of water may be allowed up to 2 hours before) .
2. **Medication adjustments**:
- Inform your doctor about all medications you take
- You may need to stop blood thinners (aspirin, warfarin, etc.) several days before
- Discuss diabetes medications as adjustments may be needed
3. **Arrange transportation**: Due to sedation, you'll need someone to drive you home and stay with you for 24 hours .
4. **Clothing and personal items**:
- Wear comfortable clothing
- Remove dentures, jewelry, glasses, or contact lenses before the procedure
5. **Consent**: You'll need to sign a consent form after discussing risks and benefits with your doctor .
Your doctor may order a CT scan before bronchoscopy to help guide the procedure, unless it's an emergency situation .
# # What to Expect During the Procedure
Bronchoscopy is typically performed in a hospital or outpatient procedure room:
1. **Preparation**:
- An IV line is placed to deliver medications
- Monitors are attached to track heart rate, blood pressure, and oxygen levels
- Oxygen may be provided through nasal tubes
2. **Sedation and anesthesia**:
- Most flexible bronchoscopies use "conscious sedation" - you're relaxed and drowsy but not fully asleep
- General anesthesia may be used for rigid bronchoscopy or certain complex procedures
- Your throat is numbed with spray or gel to reduce discomfort
3. **The procedure**:
- The bronchoscope is gently inserted through your nose or mouth
- You may feel pressure or mild tugging as it moves down your throat
- The doctor examines your airways and may take samples or perform treatments
- You might cough initially, but this usually subsides as the numbing medication works
4. **Additional procedures** that may be performed:
- Biopsy (taking tissue samples)
- Bronchial lavage (washing with saline to collect cells)
- Ultrasound examination of lymph nodes (EBUS)
- Placement of stents or other treatments
# # After the Procedure: Recovery and Results
# # # Immediate Recovery:
- You'll be monitored until the sedation wears off (typically 1-2 hours)
- Your throat will be numb for about an hour - don't eat or drink until it wears off
- You may experience a sore throat, hoarseness, or cough for 24 hours
- Most people can go home the same day
# # # Post-Procedure Care:
- Rest for the remainder of the day
- Don't drive, operate machinery, or make important decisions for 24 hours
- Start with sips of water, then soft foods before returning to normal diet
- Use throat lozenges or warm salt water gargles (once numbness wears off) for sore throat
# # # Results:
- Preliminary findings may be discussed after the procedure, but you might not remember due to sedation
- Biopsy results typically take 2-7 days, sometimes longer if special testing is needed
- Your doctor will schedule follow-up to discuss all results and next steps
# # Potential Risks and Complications
While bronchoscopy is generally safe, possible risks include:
1. **Common, minor side effects**:
- Sore throat
- Hoarseness
- Mild fever
- Temporary breathing difficulties
2. **Less common complications**:
- Bleeding (especially after biopsy) - usually minor
- Infection
- Low blood oxygen during procedure
- Irregular heart rhythms
3. **Rare but serious complications**:
- Collapsed lung (pneumothorax) - occurs in 1-3% of biopsies
- Severe bleeding
- Reaction to anesthesia
- Heart attack in people with existing heart disease
Contact your doctor immediately if you experience after the procedure:
- Difficulty breathing
- Chest pain
- Fever lasting more than 24 hours
- Coughing up more than a few tablespoons of blood
- Signs of pneumonia
# # Special Considerations
# # # Robotic Bronchoscopy:
New technologies like the MONARCH platform allow for robotically-assisted bronchoscopy, which can be particularly helpful for reaching small, peripheral lung nodules with high success rates (98.7% navigation success in recent studies) . This may lead to faster diagnosis and treatment initiation for lung cancer .
# # # Pediatric Considerations:
In children, rigid bronchoscopy under general anesthesia is more commonly used, especially for foreign body removal .
# # # Follow-up:
Depending on the findings, you may need:
- Additional tests or procedures
- Medication changes
- Further monitoring
- Referral to specialists
Remember that bronchoscopy is a valuable tool for diagnosing and treating lung conditions. While the idea of the procedure might seem intimidating, most patients tolerate it well with minimal discomfort. Your healthcare team will take all necessary precautions to ensure your safety and comfort throughout the process.
If you have any concerns or questions about your upcoming bronchoscopy, don't hesitate to discuss them with your doctor. They can provide personalized information based on your specific health situation and the reason for your procedure.
