Bronchoscopy at Parkside Hospital

What is a bronchoscopy?

A bronchoscopy is a test that lets your doctor look inside your windpipe (trachea) and the airways of your lungs. They do this using a bronchoscope, a thin, flexible tube with a light and a tiny camera on the end, passed through your nose or mouth.

Why might I need a bronchoscopy?

Your doctor may suggest a bronchoscopy:

• to look more closely at something unusual seen on a chest X-ray or scan, such as a possible sign of infection or cancer
• to find the cause of symptoms like a long-lasting cough, coughing up blood, or breathlessness that other tests haven't explained
• to take samples of cells, fluid or tissue from your airways or lungs for testing
• to check for, or occasionally clear, a blockage in your airway, such as narrowing caused by a tumour, or something breathed in by accident.

What are the benefits of a bronchoscopy?

• It lets your doctor see directly inside your airways, rather than relying on an outside picture from an X-ray or scan alone
• Samples such as washes, brushings or biopsies can be taken during the same test, rather than needing a separate procedure
• In some cases, a problem such as a blockage can be treated during the same procedure
• It's usually a day case procedure, so you can normally go home the same day.

Are there different types of bronchoscopy?

Most bronchoscopies use a flexible bronchoscope, a bendable tube that's easier to guide through your airways. Occasionally, a rigid (firm) bronchoscope is used instead, usually if something is stuck in the airway or a more complex procedure is needed.

There's also a specialist version called an endobronchial ultrasound (EBUS) bronchoscopy, which has an ultrasound scanner built in. This can reach areas a standard bronchoscope can't, such as lymph nodes, though it usually takes longer, up to an hour.

How do I prepare for a bronchoscopy?

You'll get written instructions from the hospital, but in general:

• you'll usually need to stop eating for around 6 hours beforehand, and stop drinking, except perhaps a little water, for around 2 hours before; your hospital's letter will give you exact times
• tell your doctor about all the medicines you take, especially blood thinners such as warfarin, clopidogrel or aspirin, as you may need to pause these beforehand under their guidance
• tell your team if you have diabetes, or if you use home oxygen therapy, as this may affect how you're prepared or cared for afterwards
• arrange for someone to bring you to the hospital, take you home afterwards, and stay with you for the rest of the day if you're having sedation.

What happens during a bronchoscopy?

Here's what typically happens:

1. Before you start, a nurse checks your blood pressure, heart rate, breathing and oxygen levels, and you may change into a hospital gown
2. A small tube (cannula) is placed in a vein in your arm, in case you need a sedative to help you relax – most people have a local anaesthetic, sometimes with light sedation, though occasionally a general anaesthetic is used instead
3. A local anaesthetic spray numbs your nose and throat. It doesn't taste pleasant and can make you cough briefly, but it shouldn't be painful – it may feel like you can't swallow, though you still can
4. The doctor gently passes the bronchoscope through your nose or mouth, down your windpipe and into your airways – you'll still be able to breathe normally, though you might cough a little
5. The doctor looks for anything abnormal, and may take samples, for example by washing a small amount of salt water into the lung and drawing it back out, or by taking a small tissue sample with tiny forceps
6. The whole procedure usually takes around 20 to 30 minutes, though it can take up to an hour or more for some types, such as an endobronchial ultrasound (EBUS).

What happens after a bronchoscopy?

You'll rest in a recovery area for around 1 to 2 hours while the sedative and anaesthetic wear off, and your blood pressure, pulse and oxygen levels are checked regularly.

You won't be able to eat or drink until the numbness in your throat has worn off, usually after about an hour, since swallowing isn't safe until then.

You'll usually be able to go home the same day, as long as someone can take you and stay with you. For 24 hours afterwards, you shouldn't drive, cycle, drink alcohol, operate machinery, or sign anything important, since the sedative can affect your judgement even if you feel fine.

It's common to have a sore or hoarse throat, or a mild cough, for a day or two.

What are the risks of a bronchoscopy?

There's a chance of experiencing the following:

• A sore throat, hoarse voice, or small amounts of blood when you cough or blow your nose, which usually settles within a day or two
• A temperature, aching muscles or other flu-like symptoms for a day or two
• A chest infection, which is uncommon, affecting around 1 in 100 people
• Rarely, a collapsed lung (pneumothorax), significant bleeding, or an allergic reaction to the anaesthetic or sedative
• Very rarely, a serious complication that can be life-threatening; this is thought to affect fewer than 1 in 500,000 procedures.