Bronchoscopy
Updated onValeria Dahm is a freelance writer in the medical department. She studied medicine at the Technical University of Munich. It is particularly important to her to give the curious reader an insight into the exciting subject area of medicine and at the same time to maintain the content.
More about the experts All content is checked by medical journalists.In bronchoscopy (lung endoscopy), either a rigid or flexible probe (bronchoscope) is inserted through the nose or mouth into the trachea to examine the trachea itself and its large branches - the bronchi. Read here when a bronchoscopy is performed, how it works and what risks are associated with the examination!
What is a bronchoscopy?
The term bronchoscopy is derived from the Greek words for airway / air tube (bronchus) and look (skopein). Colloquially, the examination is also called a lungoscopy, although it cannot examine the entire lungs but only the larger airways.
The bronchoscope is a thin, flexible tube or rigid tube with a tiny video camera at the front end. It is inserted into the windpipe through the mouth or nose. In order for the doctor to have an unrestricted view of the structures there, a light source and often a rinsing and suction device are also installed in the bronchoscope. In addition, special instruments such as forceps or scissors can be inserted into the airways via a working channel of the bronchoscope and small surgical interventions can be carried out during the examination (e.g. taking a tissue sample).
As mentioned, there are two types of bronchoscope. Depending on which the doctor uses, there are two types of bronchoscopy:
- flexible bronchoscopy: Flexible bronchoscopy is the most common form. The flexible bronchoscope is a soft tube with a small diameter of 2 to 6 mm, so that the risk of injury is very low. Local anesthesia is usually sufficient for this examination.
- Rigid bronchoscopy: It has been largely replaced by flexible bronchoscopy. Instead of the tube, a hard tube is inserted here under general anesthesia. The advantage lies in the larger working channel and greater stability, which can also be used for more complex interventions with more effort (e.g. punching tissue samples from the trachea or bronchial wall).
When do you do a bronchoscopy?
Bronchoscopy is used for both diagnosis and therapy of lung diseases.
Diagnostic indications
- Inflammation of the lungs (pneumonia)
- chronic cough of unknown cause
- Clarification and sampling (biopsy) in the case of benign and malignant tumors or other changes in the airways
- Tissue swabs are taken with the help of small brushes
- Coughing up blood (hemoptysis)
- unclear lung changes on chest x-ray
Therapeutic indications
- Removal of inhaled foreign bodies
- Aspiration of tough mucus
- Lung lavage (bronchoalveolar lavage, BAL) with saline solution (sometimes also used diagnostically)
- Hemostasis
- Widening constrictions of the bronchi with special tubes (stents)
- Introduction of radiating elements (radio nuclides) for local radiation therapy in lung cancer
What do you do with a bronchoscopy?
Before the actual examination, your doctor will ask about your medical history (anamnesis) in a short conversation and explain the possible complications of a bronchoscopy. In addition, a blood count is taken and a lung function test (lung function test) is carried out. In some cases, an x-ray or computed tomography of the lungs and an EKG are necessary.
Before the bronchoscopy, you should not consume food or drinks such as milk or coffee with sugar for eight hours to reduce the risk of inhaling (aspiration) of stomach contents.
Since the airways have no pain fibers, only inserting the bronchoscope through the nose or throat is uncomfortable and can trigger a cough. With flexible bronchoscopy, local anesthesia and light sedatives are sufficient. With rigid bronchoscopy, on the other hand, general anesthesia is always necessary.
The doctor carefully inserts the bronchoscope and inspects the mucous membrane on the way to the bronchi. The airways of the lungs branch like a tree from the windpipe into the bronchi. Usually the doctor examines the branches up to the third or fourth branch. Where necessary, further instruments for taking samples can now be introduced via the working channel and smaller operations can be carried out. After the procedure, blood residues and secretions are liquefied with physiological saline solution and suctioned off. The doctor will now remove the bronchoscope and you will be taken to the recovery room for further monitoring.
What are the risks of a bronchoscopy?
There are hardly any risks with bronchoscopy. However, the examination is not completely risk-free - complications rarely occur, sometimes even if the examination is carried out carefully:
- Injuries to the airways with penetration of the bronchial wall (perforation)
- Bleeding
- Collapse of one or both lungs (pneumothorax) due to injury to lung tissue
- involuntary spasms of the airways and / or larynx muscles (bronchospasm)
- Lack of oxygen (hypoxia)
- Irregular heartbeat and low blood pressure (hypotension)
- Swelling of the larynx (laryngeal edema) or injuries in the area of the larynx
- Inflammation (in the hours and days after the procedure)
What do I have to consider after a bronchoscopy?
After the bronchoscopy, you will remain under medical observation for some time. Due to the narcotics or anesthetics, you are not allowed to eat anything for at least an hour, otherwise you could choke. In addition, you should not take part in road traffic for 24 hours or use public transport, as the after-effects may cause you to be less reactive. So let someone pick you up to take you home.
Your doctor will discuss the examination results and any follow-up interventions with you. If a tissue sample was taken during the bronchoscopy (biopsy), you will usually receive the test result after two to three days.
Tags: pregnancy birth news fitness
