Bronchoscopy is the procedure of looking into the windpipe (trachea) and smaller airways (bronchus) with a telescope.
Thoracic surgeons perform bronchoscopy with a straight camera, this is done with you fully asleep under a general anaesthetic.
What is bronchoscopy used for?
- It is part routine practice to look at the airway before the start of thoracic surgery to check for any abnormalities and clear mucus
- Biopsies can be taken
- Foreign objects can be removed
- Additional procures can be done to unblock or widen the airway. This include dilating (widening) the airway, removing abnormal tissue, or placing a stent.
Sometimes people are very unwell from the airway being very narrow or bleeding in the airway. Lung tumours can block the airway and cause severe shortness of breath. We may be able to perform bronchoscopy as an emergency to help.
What is recovery like?
Most people are admitted on the day of the procedure and can go home again later the same day without having any problems. After a general anaesthetic you can feel quite tired for a few days. You should not work or drive for 48 hours afterwards. It is normal to have a sore throat after a bronchoscopy, this should settle over a few days. You can use painkillers as usual at home if required.
If you have an additional procedure you may need to stay in hospital overnight for monitoring. If you have a bronchoscopy as an emergency you will need to stay in hospital afterwards for monitoring and recovery.
What are the risks?
Complications after bronchoscopy are uncommon.
- Damage to the teeth or mouth
Even with great care there is a risk of damage from equipment.
- Coughing up blood
A small amount for a few days is normal. You may need to stay in hospital or have another operation if there is a lot of bleeding
- Pneumothorax
Rarely bronchoscopy may cause a pneumothorax, commonly referred to as a collapsed lung, this would make you feel short of breath. You may need to have a chest drain and stay in hospital until it settles.
- Chest infection
- Making a hole in the airway (perforation)
- Temporary low oxygen levels
Extra procedures during bronchoscopy
- Dilatation
Dilatation is widening of the airway. A small balloon is passed into the airway and expanded, this pushes the airway open. On its own, dilatation is most commonly used to treat people who have a narrowing of the airway that is not due to cancer. The narrowing may have occurred after having a tube in the airway for a prolonged period, such needing help with breathing on an Intensive Care Unit. The cause may not be known. Narrowing frequently comes back after dilatation, the procedure can be repeated. Tracheal resection may provide a long term solution for certain patients.
- Removing tissue and laser
Tissue can be removed using forceps to clear the obstruction. This may be used on its own or in combination with a laser. A Laser beam can be used to burn away tissue that is blocking the airway. There is a small amount of bleeding with either of these procedures. Bleeding can normally be controlled during the bronchoscopy. Heavy bleeding is very rare. If there is a lot of bleeding you may need a blood transfusion. If there is damage to a major blood vessel, bleeding could be fatal.
- Stents
Stents are tubes that can be placed inside the airway after dilatation. They help prop the airway open and make breathing much easier. They are most commonly used to help manage symptoms of lung cancer. Stents may become displaced or make it difficult to clear mucus from the lungs. They may stimulate extra tissue to form, narrowing the airway again. Very rarely a stent may wear away a section of the airway and damage a blood vessel or the gullet (oesophagus).