Introduction:
A bronchoscopy is used by pulmonologists to visualize the air passages and lungs. The bronchus is connected to the lungs. During inhalation, the bronchi distribute the air to the lungs. The bronchoscope is inserted through the nose or mouth to reach the lungs. A camera is attached to the bronchoscope to examine the bronchus. There are two types of bronchoscopy - flexible type and rigid type.
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Flexible Bronchoscope: Flexible type is the most commonly used bronchoscope. Medications are administered during the procedure for relaxation.
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Rigid Bronchoscope: Rigid type is used in case of any internal bleeding in the lungs or if the airway is obstructed by any foreign object. This procedure is performed under general anesthesia.
What Are the Uses of Bronchoscopy?
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The bronchoscope is used to visualize the respiratory system with the help of a camera and a light source. The light source gives a clear image of the structures visualized. The respiratory system comprises the larynx (voice box), trachea (windpipe), bronchi (airway to lungs), and lungs.
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With the help of bronchoscopy, doctors can diagnose the problems associated with the lungs. The infection inside the lungs can be observed using bronchoscopy.
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The secretions in the airway are collected for diagnosis of lung disease using bronchoscopy.
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The stages of the tumor are identified. The nature of the lung tumor, either benign or malignant, is detected using bronchoscopy. The affected tissue in the lungs is removed with the bronchoscopy for the biopsy report.
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Any obstruction in the airways due to foreign objects can be visualized using bronchoscopy.
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Bronchoscopy is not only used for diagnosis but also for treatment purposes. Interventional bronchoscopy is used to treat a pneumothorax (a condition in which the lung collapses), internal bleeding in the lungs, and unusual narrowing of the bronchus (stricture).
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The bronchus (airway) is held open with the support of a small tube called a stent. This stent is placed inside the bronchus using bronchoscopy.
What Are the Other Tools Used in Bronchoscopy?
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During a biopsy, a tool is passed through the bronchoscopy for tissue excision. Skillful techniques are used to remove the sample from the lungs.
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An electrocautery tube is used to control the internal bleeding in the lungs.
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A laser is used to reduce the size of the tumor present in the airways.
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The tumor in the lungs can cause inflammation in the lymph nodes located in the chest. These lymph nodes can be observed using endobronchial ultrasound (EBUS).
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Endobronchial ultrasound is also used to determine the extent of the cancer spread for appropriate treatment.
What Are the Risks Associated With the Bronchoscopy?
Severe complications are rare. Complications arise if there are any postoperative infections. A few conditions are listed below:
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Fever - It is the most common symptom after bronchoscopy. Fever usually recovers in a day with proper medications.
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Sedation - Bronchoscopy is usually performed under conscious sedation. Postoperatively, general anesthesia results in nausea and vomiting.
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Postoperative Infection - The infection can cause inflammation in the airways.
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Bleeding - Bleeding can occur in the nose or mouth after the biopsy procedures. If there is minimal bleeding, treatment is not necessary.
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Pneumothorax - The possible injury to the airway in the bronchoscopy is rare. In case of any damage to the lungs, the air gets trapped in the cavity, causing lung collapse. This condition is treated in the hospital by the doctor.
What Are the Instructions to Follow During Bronchoscopy?
Before the procedure, there are certain steps to follow:
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Anticoagulants - Medications like blood-thinning tablets (anticoagulants) must be stopped a few days before the bronchoscopy as per the doctor's advice. These medications include Aspirin, Clopidogrel, and Warfarin.
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Food And Drinks - There are few restrictions on eating and drinking. Avoid food and drinks for four to eight hours before the bronchoscopy.
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Remove The Objects - Remove personal items like jewelry, glasses, and contact lenses. The removable dentures must be removed to avoid any hindrance during the bronchoscopy.
What Are the Other Necessary Precautions to Follow?
It is always advisable to do the procedure during the daytime. Do not drive the vehicle after the procedure, as the anesthesia takes time to wear off. It is better to have a caretaker or friend, or family member to support you mentally and physically after the procedure. The procedure lasts for an hour. In addition to that, the preoperative and recovery time takes around four to five hours.
How Is the Procedure Performed?
A monitor is connected to monitor the heart rate and blood pressure during the procedure. The bronchoscopy is performed either in a sitting or lying position. General anesthesia is given intravenously. Medication is sprayed in the throat to avoid gagging and coughing during the insertion of bronchoscopy. A topical anesthetic gel is applied over the nose to numb the area.
The bronchoscope is inserted either through the nose or mouth. A light and camera are attached to the bronchoscope and the monitor. The monitor shows pictures of internal structures like airways, blood vessels, and lungs. It makes the doctor perform the bronchoscopy procedure with ease.
The bronchoscope is passed through the throat initially and then proceeds slowly into the vocal cords and airways. During the insertion, slight discomfort is felt.
A special tool is inserted through the bronchoscope to collect the sample from the tissue and secretion. The doctor performs the procedure skillfully to avoid injury and pain.
What Are Post Operative Measures in Bronchoscopy?
Avoid food and drinks for a few hours after the procedure since the anesthesia takes time to wear off. The water should be taken in sips once the numbness has subsided. Avoid eating spicy foods for a few days. Eat soft foods and liquids that are comfortable to swallow. Gargle the throat using warm water.
Conclusion:
The results of a biopsy taken during the bronchoscopy are examined by the doctor. It usually takes around three days to one week. The sample is used to detect the problems in the lungs. If the results are normal, it indicates that the lungs are healthy. Any infection in the lungs can be detected in the mucous secretion with the help of bronchoscopy. The abnormal results may be due to the abnormal condition in the air sacs (alveoli) or bronchi. The diseases like sarcoidosis and actinomycosis can also be inspected with bronchoscopy.
