What is a bronchoscopy?

A bronchoscopy is a minimally invasive procedure used to diagnose and treat respiratory conditions. Bronchoscopy involves inserting a bronchoscope through your mouth or nose and passing it into your airways and lungs. A bronchoscope is a lighted, tube-like instrument with a camera for examining the inside of your airways. 

Bronchoscopy is only one method of diagnosing and treating lung-related diseases. Discuss all your options with your doctor to understand which choices are best for you.  

Types of bronchoscopy

The types of bronchoscopy procedures include:

  • Flexible bronchoscopy involves passing a thin, flexible bronchoscope through your nose or mouth, down your throat, and into your airways. The bronchoscope has a light and small camera that allows your doctor to see and take pictures of your windpipe and airways.
  • Rigid bronchoscopy involves passing a wider and stiffer bronchoscope through the mouth. This larger bronchoscope can accommodate special instruments used for treatments. Treatments include removing a foreign body, inserting special ultrasound equipment, treating bleeding, and placing stents to keep the airway open.

Why is a bronchoscopy performed?

Your doctor may recommend a bronchoscopy to diagnose and treat certain conditions of the trachea (windpipe), bronchi, and lungs. 

A diagnostic bronchoscopy allows your doctor to examine the lungs and airways and take a biopsy. A biopsy involves removing tissue samples to test for cancer and other diseases. A diagnostic bronchoscopy can help diagnose the cause of the following conditions and situations:

  • Abnormal findings on a chest X-ray or CT
  • Atelectasis (lung collapse)
  • Cancer or tumors including lung or tracheal cancer
  • Chronic cough lasting several weeks
  • Interstitial lung disease (inflammation of deep lung tissues)
  • Lung abscess
  • Lung bleeding including coughing up blood 
  • Swelling or injury of the vocal cords, trachea (windpipe), or other airways

A therapeutic bronchoscopy provides treatments. It allows your doctor to:

  • Insert an endotracheal tube into the trachea to permit mechanical ventilation
  • Place medication directly on a lung problem
  • Place a small tube or stent to hold the airway open
  • Remove a foreign object
  • Remove all or part of a tumor
  • Suction excessive secretions in the deep airways in the lungs

Who performs a bronchoscopy?

Pulmonologists and thoracic surgeons perform outpatient bronchoscopies.

Pulmonologists are internists or pediatricians with specialized training in treating diseases and conditions of the chest, such as pneumonia, asthma, tuberculosis, emphysema, or complicated chest infections. Thoracic surgeons specialize in surgical treatment of diseases of the chest, including the blood vessels, heart, lungs and esophagus.

How is a bronchoscopy performed?

Your bronchoscopy will be performed in a special bronchoscopy room or lab in a clinic or hospital. It is also performed in surgery and in the intensive care unit (ICU) for in seriously ill patients.

The procedure takes about four hours, including preparation and recovery time. It generally involves these steps:

  1. You will undress and put on a patient gown. Your care team will provide sheets or blankets for modesty or warmth.
  2. Your care team will position you on a special table or bed and start an intravenous (IV) line.
  3. You will receive anesthesia and medication to make you comfortable during the procedure. For flexible bronchoscopy, this is generally a local anesthetic, such as lidocaine spray, to numb your mouth and throat. You will also have oral or IV sedation to make you relaxed and sleepy. For rigid bronchoscopy, you will likely have general anesthesia to make you completely unaware of the procedure.  
  4. Your doctor will insert the bronchoscope through your nose or mouth and pass it down your throat into your trachea (windpipe) and lungs.
  5. Your doctor will take pictures of your airways. Your doctor might insert tiny instruments through the bronchoscope to take a biopsy and perform a treatment. Treatments include removal of a tumor or foreign object and washing out the lungs with a special saline solution. 
  6. Your doctor will remove the bronchoscope.
  7. Your care team may take a chest X-ray to check for lung problems or damage due to the procedure.