What is a Bronchoscopy?

A bronchoscopy is a procedure whereby a thin soft tube-like instrument called a bronchoscope is inserted through your nose or mouth and down into the airways of the lungs. The tube has a mini-camera at its tip,and is able to carry pictures back to a video screen or camera. It is usually done using conscious sedation i.e. you will be given a medication to make you sleepy. Using a bronchoscope the doctor is able to see the interior of the airway and any abnormality associated with it and decide upon the type of sample to be taken.

When is a Bronchoscopy?

A bronchoscopy is used to evaluate lung symptoms such as a chronic cough, the coughing of blood or when lung disease or cancer is suspected after xray studies. During a bronchoscopy, doctors are able to see the inside of your airways. If there are areas that are abnormal, a biopsy or lavage (the collection of your secretions) can be done in order to diagnose lung disease or cancer. In addition, a bronchoscopy may also be used for treatment e.g. to temporarily stop bleeding in the airways or in the case of airway narrowing, to insert a stent to open up the airway.

Preparing for a Bronchoscopy

Before performing a bronchoscopy, your specialist will talk to you about the procedure, the risks involved and what he may expect to find. You will be asked to sign a consent form. If you are on any blood-thinning medications, such as aspirin, clopidogrel (Plavix) or warfarin (Coumadin), you may be asked to discontinue these for a period of time before the test. In addition, you will be asked to fast (not eating or drinking) for 4-6 hours before the bronchoscopy.

The Bronchoscopy itself

At the start of the bronchoscopy, you will be given a local anaesthetic to numb your throat and nose, and a medication to make you sleepy. The duration of the bronchoscopy can vary, anywhere from 10 minutes to 1 hour, depending on what the specialist sees during the procedure and what needs to be done, e.g. biopsy. Throughout the procedure, your blood pressure, heart rate and oxygen level will be continuously monitored.

What happens after the Bronchoscopy?

After the bronchoscopy, you will be monitored for 2-4 hours in the recovery area. Your throat may be irritated and you may continue to feel groggy because of the sedatives administered to you. Typically, you are only able to eat and drink after 2-3 hours. You may cough up small amounts of stale blood for a day or two. As the effects of the medications can last for several hours, it is important that you are accompanied by someone who will be able to take you home.

Possible complications of Bronchoscopy

A bronchoscopy is usually very well-tolerated and usually very safe procedure with hardly any complications. Every effort will be made to conduct the procedure in such a way as to minimize discomfort and risks. However, just as with other types of procedures, there are inherent potential risks. The incidence of major complications associated with bronchoscopy are 0.8% – 1.3%. The mortality rate associated with bronchoscopy is < 0.01. Occasionally, the following complications may occur:

 Bleeding or pneumothorax (collapse of the lung due to a collection of air trapped in the cavity between the lung and the chest wall). These complications can occasionally occur, especially after a biopsy.

 Post-procedure fever which lasts for a day or two

 Hoarseness

 Infection

 Spasm of the airway, leading to breathlessness

 Heart complications such as an abnormal rhythm or even a heart attack

 Complications related to the sedative medications.