Bronchoscopy, also known as lung endoscopy, is used to diagnose and treat diseases of the respiratory tract. To perform the procedure, the doctor inserts a flexible or rigid endoscope—the bronchoscope—into the trachea and bronchi. Flexible bronchoscopy is less invasive for the patient. For this reason, this procedure has become the standard of care over rigid bronchoscopy, except for a few specialized applications.
Here you will find further information as well as a selection of bronchoscopy specialists and centers.
Bronchoscopy, also known as lung endoscopy, is a modern routine procedure in pulmonology (the study of the lungs). It is used to examine the airways using a flexible tube or a rigid tube. The airways include the trachea and the bronchi.
A bronchoscopy is primarily used to diagnose diseases of the airways. In addition, the doctor can also remove foreign objects and tumors during the procedure.
The term “lung endoscopy” is misleading: The bronchoscope cannot be advanced all the way into the fine airways of the lungs (bronchioles) or the alveoli.
The anatomy of the respiratory tract © bilderzwerg / Fotolia
When is a bronchoscopy performed?
Bronchoscopy is frequently performed in cases of
- unclear abnormalities on X-rays or CT scans,
- bronchial tumors,
- respiratory tract infections and inflammation (e.g., bronchitis, bronchiectasis), as well as
- a persistent, unexplained cough or coughing up blood
. Using a camera attached to the bronchoscope, the doctor can view the trachea and bronchi from the inside. This allows the doctor to identify abnormalities in the airways and, if necessary, treat them immediately. Green laser light is used for this purpose—the video shows the procedure:
An overview of the applications of bronchoscopy:
- Diagnosis/examination via bronchoscopy: Diagnosis of lung and bronchial tumors (lung cancer), collection of tissue samples (biopsies), and performance of a smear test.
- Treatment / Therapy via Bronchoscopy: Removal of foreign bodies, tumors, hemangiomas, and thick mucus from the airways, as well as stopping bleeding and inserting stents.
What types of bronchoscopy procedures are there?
A distinction is made between rigid bronchoscopy and flexible bronchoscopy.
Flexible bronchoscopy is performed using a flexible, maneuverable endoscope. It adapts well to the anatomical conditions. The procedure is relatively gentle and generally does not require general anesthesia. Most therapeutic and diagnostic procedures can now be performed using a flexible bronchoscope.
Rigid bronchoscopy, on the other hand, is somewhat more invasive. The tube is not flexible but rather a rigid tube with a slightly larger diameter. General anesthesia is required for the procedure. For this reason, rigid bronchoscopy is now used only for specific applications.
This makes it easier to remove larger foreign bodies or tumors using lasers and to insert stents.
How is a bronchoscopy performed?
Bronchoscopy is usually performed on an outpatient basis. However, if the patient has severe comorbidities or an increased risk of bleeding, they are admitted to the hospital.
Pain relief is not necessary, as the airways are not sensitive to pain. However, mild sedation or general anesthesia is required to suppress the gag and cough reflexes.
The doctor then inserts the bronchoscope through the mouth or nose, guiding it down the trachea and into the large bronchi. A camera at the tip of the bronchoscope transmits images of the airways to a monitor.
Bronchoscopy specialists can then use the images to assess the condition of the trachea and bronchi. If abnormalities are found, they can insert very small forceps and other instruments through the bronchoscope. These are used to remove tissue samples or foreign objects.
After the bronchoscopy, the patient must not eat or drink anything for about 2 hours. Depending on the type and purpose of the procedure, a bronchoscopy can take up to 30 minutes.
What complications can occur during a bronchoscopy?
Bronchoscopy is generally associated with few complications. The mechanical stress involved in inserting the bronchoscope can occasionally cause bleeding and a sore throat. This is particularly likely after tissue samples have been taken. Hoarseness and coughing may also occur.
It is very rare for the doctor to injure the larynx or cause a pneumothorax during the examination.
Bronchoscopy is not possible for patients in poor general health or with certain pre-existing conditions. In such cases, bronchoscopy specialists will carefully weigh the risks and benefits of this procedure.
Which specialists and specialized clinics perform bronchoscopy?
Bronchoscopy specialists are often physicians specializing in internal medicine with a focus on pulmonary and bronchial medicine.
Clinics that perform bronchoscopy are typically
- specialized pulmonary clinics,
- pneumology and allergology clinics,
- oncology clinics, and
- thoracic surgery clinics.