A bronchoscopy is a medical procedure that provides a view into a patient’s air passages and lungs. This procedure is conducted by a pulmonologist who passes a specialized piece of equipment called a bronchoscope into the lungs.
The tube takes the route through the patient’s nose or mouth and passes through the throat to reach the lungs. Patients might experience some discomfort, but this procedure is usually painless.
Doctors normally use a flexible bronchoscope for this procedure. However, under certain conditions, for example, if there is an obstruction in the patient’s airways or bleeding in the lungs, a rigid bronchoscope might be used.
A bronchoscopy could be performed for a variety of reasons. Normally, a pulmonologist may recommend one if certain symptoms cannot be explained by a chest X-ray. It may also be required if something unusual shows up in a chest X-ray.
As stated earlier, there are two types of bronchoscopes – flexible and rigid:
This instrument comes in slightly varying diameters. We use it to reach into the airways to extract secretions and liquids in the narrowest airways. It also serves to apply medication to the lungs or collect tissue samples.
We use a rigid bronchoscope to enter larger airways. It helps us remove larger quantities of internal matter from the lungs, and we can also use it to remove lesions and add stents, among various other functions.
The flexible bronchoscope is the most widely-used bronchoscope by pulmonologists. This instrument is generally a long fibreoptic cable. It carries instruments on its tip and often even a video tip to provide a video image with illumination.
The fibreoptic cable records data and transmits it to instruments on the outside. These instruments process the data from within the lungs, providing a real-time image or a host of parameters that can be either read out on a monitor or printed.
The tip of the bronchoscope can be angulated to give a 360° view of the inside of a patient’s lungs and airways. Most flexible bronchoscopes are fitted with tubes that can carry liquids in either direction.
The purposes can be many, such as depositing liquid medications, suctioning liquids, or clearing the lens at the tip of the bronchoscope.
The primary consideration for a flexible bronchoscope is the diameter of the fibreoptic cable. Owing to the small diameter of the airways leading to the lungs, the diameter of the cable needs to be proportionately small. It needs to allow the patient sufficient airway space to breathe even with the instrument fully inserted.
An adult-size flexible bronchoscope is typically 4.9 mm in diameter. If required, it can be used on children as young as four years old. The larger the diameter of the instrument, the more the scope for obstruction in the airway. However, this also provides a better image resolution and a larger suction channel.
When it comes to children, the size of a paediatric instrument may range from 2.8 mm to 3.7 mm. An ultra-thin version is also available, but it does not have a suction channel. Paediatric fibreoptic bronchoscopes can be used on patients of almost any age. However, the airway of a baby weighing less than 2.5 kg could be totally obstructed.
The tiny glass fibres that make up the bronchoscope reflect thousands of points of light and colour – this is what we finally see on the screen. The image resolution of a flexible bronchoscope is not as high as that of a rigid one. However, the image output we get is sufficient for observing the required details.
A doctor might recommend a fibreoptic bronchoscopy if a patient has an unresolved lung issue which cannot be diagnosed by X-rays or other techniques. In such cases, flexible bronchoscope methods can produce satisfactory results.
Patients are likely to need a flexible fibreoptic bronchoscopy for:
- Detection of a lung infection
- Removal of secretions or obstructions like a foreign body
- Stent placement
- Widening the airways
- Lung issue diagnosis
- Biopsy purposes
- Viewing or treating a tumour
- To treat bleeding lungs
- To rectify a collapsed lung
The doctor passes a thin tube through the patient’s nose or mouth into their airway and lungs via the throat. At the end of the flexible bronchoscope is a tiny camera which takes pictures or videos of the inside of the airway and lungs.
Since the bronchoscope passes through the vocal cords as it passes through the throat, the patient may have the urge to cough. In addition, patients cannot speak during a bronchoscopy. However, they shouldn’t be alarmed – their voice will return back to normal after the procedure.
Application of anaesthesia to the inner walls of the throat is a part of the procedure to reduce discomfort. If patients feel more pain, they can signal to the doctor, who will apply more anaesthesia.
Patients might also experience a choking sensation while the flexible bronchoscope is inserted. However, they need not panic as their oxygen levels will be monitored closely. The doctor will ensure that patients get enough air to breathe throughout the procedure.
When patients first hear about it, the thought of a flexible bronchoscope may sound a bit scary. But it is no scarier than a stethoscope or the spatula that an ear, nose, and throat (ENT) specialist might insert into the throat.
Today, flexible fibreoptic bronchoscopy has evolved tremendously. The data collected or the features bronchoscopes offer are phenomenal. Technology has also enabled flexible bronchoscope methods to be more comfortable and totally painless.
A flexible bronchoscopy is a relatively common procedure that does not necessarily indicate that there’s something seriously wrong with a patient. Further, patients can be assured that their doctor will be with them to make them as comfortable as possible throughout the procedure.
To avail of a hassle-free flexible fiberoptic bronchoscopy, visit the C.K. Birla Hospital or book an appointment with Dr Vikas Mittal who will provide you with personalised treatment. Our highly-qualified healthcare professionals perform bronchoscopies using state-of-the-art facilities and cutting-edge technologies.