Table of ContentsView AllTable of ContentsPurpose of the TestRisks and ContraindicationsBefore the TestDuring the TestAfter the TestInterpreting the Results
Table of ContentsView All
View All
Table of Contents
Purpose of the Test
Risks and Contraindications
Before the Test
During the Test
After the Test
Interpreting the Results
A bronchoscopy is an endoscopic medical procedure that is used to look inside the airways (bronchi) and the lungs. It involves inserting a bronchoscope—a narrow tube that has a light and a camera on one end—through the nose or mouth and guiding it down through the trachea (windpipe) in order to get an internal view of the respiratory system. It may be done to diagnose a disease or condition such aslung canceror infection, or to treat a medical problem such as a foreign object that’s lodged in the airways.
There are two main reasons a person might need a bronchoscopy:
Evaluation
Your healthcare provider may opt to perform a bronchoscopy to evaluate symptoms and other indications that something may be wrong with the lungs or airways. Examples include:
A bronchoscopy also can be used to take a biopsy of abnormal lung or airway tissue, to biopsy the lymph nodes in the central chest adjacent to airways for evidence of cancer involvement, and to visualize tumors within the lungs that do not extend into the bronchi using a technique known asendobronchial ultrasound(EBUS).
In this procedure, a tumor deep in the airways may be visualized with ultrasound and biopsied during a bronchoscopy (an ultrasound-guided needle biopsy). EBUS can also be used to obtain a sample from lymph nodes that are adjacent to the airways.
In addition to techniques designed to look deeper than the airways during a bronchoscopy, there are also several new technologies used to diagnose early lung cancers. These include radial EBUS bronchosopy, robotic assisted bronchoscopy, narrowband imagery, and high magnification video bronchoscopy.
Treatment
By providing both access and a direct view of the inside of the airways and lungs, a bronchoscopy can allow a healthcare provider to perform all sorts of treatments, such as:
Bronchoscopy can also be used as part of certain treatments for lung cancer that is in or near the large airways. It might be used to assist with a procedure called brachytherapy, for instance, in which radiation is delivered directly to a tumor through the bronchoscope.
There are two types of bronchoscopy. The most common uses only aflexible bronchoscopeand requires on local anesthesia and a light sedative; sometimes general anesthesia is necessary, depending on the length of the procedure. Less often arigid bronchoscope, which is thicker than a flexible one and typically made of metal, is necessary. In that case, a patient must be under general anesthesia in an operating room.
Which one your healthcare provider opts for will depend on the purpose of the test and your overall condition.
Most people tolerate both types of bronchoscopy quite well. There are some potential risks, however.Though they are not common, they include:
Because general anesthesia is required, there are a few additional risks associated with rigid bronchoscopies, such as:
There are some conditions and situations that make having a bronchoscopy (of either type) inadvisable or impossible. The most common ones are:
There are a few people who can safely have a bronchoscopy for viewing purposes, but for whom caution should be taken if doing a biopsy. These are patients who have:
Inspection of the airways is safe in these patients, however.
Bronchoscopy is a common test in pulmonology. That said, it might be all new to you. Knowing a little more about it can help you enter your test confidently.
Timing
The amount of time it takes to perform a bronchoscopy varies depending on the reason it’s being done and whether any other procedures will be done at the same time, such as a biopsy. Typically, though, a bronchoscopy itself takes between 30 minutes and 60 minutes. With preparation and recovery time, the entire process (from when you check in until you’ve recovered and are free to leave) usually takes about four hours. Ask your healthcare provider for an estimate of how long the procedure is likely to last in your case.
Location
Bronchoscopy is done in a hospital. A flexible bronchoscopy may be done in a special procedure suite. A rigid bronchoscopy is performed in an operating room. In some cases, the procedure may take place in an intensive care unit of a hospital.
What to Wear
Dress comfortably in clothing that can be easily removed and put back on, as you will be asked to change into a hospital gown. It’s always a good idea to leave jewelry and other non-essential personal items at home so you don’t risk losing them. You also may need to remove dentures, bridges, hearing aids, contact lenses, or eyeglasses.
Food and Drink
You should not eat or drink anything for six to 12 hours beforehand.
In advance of the procedure, you may also need to take a break from certain medications or supplements that could cause problems during the bronchoscopy or interact with anesthesia or other drugs you may be given. Be upfront with your healthcare provider about everything you take and follow her advice accordingly.
Medications that typically should be stopped in preparation for bronchoscopy include any that can interfere with blood coagulation—in other words, that cause blood to thin. Common ones are:
Cost and Health Insurance
If you will be paying for the procedure, abronchoscopy can cost around $3,000, depending on your location.
What to Bring
Your healthcare provider will instruct you as to what you should bring. This likely will include your health insurance card and personal identification (typically a driver’s license). Ask if there will be much downtime before the procedure; if so, you might want to bring a book or some other activity to keep yourself occupied. You will also need to bring along someone who can drive you home.
Other Considerations
Make sure you have a reliable ride to and from the hospital on the day of the procedure. (In rare cases, a patient may need to stay in the hospital overnight.)
Be prepared to rest the day after. Let your employer know you’ll need to take the day off, arrange for childcare or other help around the house, hire a dog walker, or ask a friend or family member to be around to help with other daily tasks, if possible.
You will interact with several people—a healthcare provider, nurse, respiratory therapist, and perhaps an anesthesiologist—during your bronchoscopy. The procedure itself can vary slightly depending in large part on whether you’ll be having a flexible or rigid bronchoscopy and if you’ll be having a biopsy or some sort of therapy at the same time. In general, here’s what you can expect.
Pre-Test
When you arrive at the hospital, there may be paperwork to complete. You’ll then be asked to change into a hospital gown and perhaps to remove your jewelry, glasses, hearing aids, or other items. You’ll then be escorted to a table or hospital bed and asked to lie down.
Once there, a nurse will place an IV (intravenous) line into your arm. She will fit you with monitors so that your blood pressure and heart rate can be checked throughout the procedure and will connect you to a device called a pulse oximeter so that your blood oxygen levels can be monitored. You may be fitted with a nasal tube or oxygen mask so that you can receive oxygen during the procedure.
For a flexible bronchoscopy, you will undergo what is called conscious sedation: You’ll be given a medication to make you sleepy (twilight sleep) and one to help dry secretions in your lungs. A local anesthetic will be used to relax and numb your throat or nose before the bronchoscope is inserted. This may have a bad taste and cause you to cough temporarily, but both ill effects will subside quickly. This is all to prevent you from gagging.
Throughout the Test
If you are under general anesthesia for a rigid bronchoscopy, you won’t be aware of any sensation or activity during your procedure. If you’re under conscious sedation for a flexible bronchoscopy, however, there are times you may be faintly aware of what’s going on.
First, the healthcare provider performing the test will insert the tip of the bronchoscope where the camera is located into your mouth or your nose and then guide it down the back of your throat, through your vocal cords, and into your airways. As the tube moves through your windpipe, you may feel a slight sensation of pressure or tugging. You may even feel you aren’t able to breathe, but there is no risk that this will happen. You’ll actually be able to breathe around the tube, but won’t be able to talk or swallow. Saliva will be suctioned from your mouth as it accumulates.
What the healthcare provider does once the bronchoscope is in will depend on the extent of the procedure. He may start with a procedure called lavage in which saline solution is sent through the tube and into the airways to wash them out and make it easier to collect samples of lung cells, fluids, and other materials in the air sacs.
If the goal is simply to view the inside of the airways—to find the source of a persistent cough, for instance—the healthcare provider may manipulate the camera in order to get a good look at areas of concern and then remove the tube once that’s been accomplished.
If the purpose of the procedure is to take samples of tissue or fluid, to remove a foreign object, place a stent, or administer radiation, any devices required to do these things will be threaded through the tube. While this is happening, and depending on your level of sedation, the healthcare provider may ask you if you’re feeling pain in your chest, back, or shoulders. He also may have you hold your breath for short periods of time.
Sometimes a healthcare provider will perform anendobronchial ultrasound(EBUS) during a bronchoscopy to get additional information about the health of your lungs. Often this is done to check the lymph nodes in the chest of someone who has lung cancer in order to determine what type of treatment is required.
Once all procedures associated with the bronchoscopy are complete, the tube is gently withdrawn. If you’re receiving anesthesia, it will be stopped. You will be taken to a recovery room.
Post-Test
What happens after your bronchoscopy will depend in part on what type you had.
After a flexible bronchoscopy, you may continue to feel drowsy as the effects of sedation wear off. You also may have a headache or feel nauseous. You will be monitored until you’re alert and recovered enough to go home. A pulse oximeter will be clipped onto your finger to measure the oxygen levels in your blood. Your blood pressure will be checked with arm cuff every 15 minutes or so.
If you have general anesthesia for a rigid bronchoscopy, you will wake up in the recovery room. When you do, you’ll feel tired, groggy, and perhaps sick to your stomach, and may have a dry mouth and sore throat. You may also feel cold and shivery until the effect of the anesthesia wears off. This can take several hours; don’t be shy about asking for extra blankets. A nurse will monitor you during this time. If you’re really nauseous or start vomiting, you may be given medication to soothe these side effects of the anesthesia.
After either type of bronchoscopy, an X-ray of your chest may be taken to make sure there was no damage to your lungs during the procedure. You also may be asked to gently cough up and spit out some saliva to be examined for traces of blood.
Whichever type of bronchoscopy you have, you will need to be driven home afterward. If you had general anesthesia, you may continue to feel the effects of it for 24 hours or so. For that reason, you’ll likely be advised to not drive or make important decisions until a full day after your procedure. Otherwise, you should be able to resume your normal diet and activities unless your healthcare provider gives you other instructions.
Managing Side Effects
Most of the immediate side effects of bronchoscopy and general anesthesia, if you have it, will resolve before you’re allowed to leave the hospital. Two that are related and likely to linger for a few days are a sore throat andhoarseness. Your throat is bound to be tender after having a tube of any size threaded through it. You may even experience mild bleeding at the site of a biopsy, if taken.
If your throat continues to hurt and you’re hoarse for more than five to seven days after your bronchoscopy, let your healthcare provider know. There are also other side effects to look for.Let your healthcare provider know if you develop any of the following rare side effects of bronchoscopy:
If the results of your test are normal, it means that only normal cells and fluids were found, and there was no evidence of a foreign substance or blockage.
Abnormal results could include any of the following:
You may need further tests if an abnormality is found during your bronchoscopy. The type of test will depend on the nature of the finding, of course. If it turns out you have an infection or other treatable condition, your healthcare provider will prescribe the appropriate medication or go over your options for treatment if there are any.
A Word From Verywell
Given its versatility for both diagnosis and treatment of myriad medical conditions, bronchoscopy is clearly an important and useful procedure. It also is very safe, takes only a few hours, causes minimal side effects, and requires little recovery time.
While the prospect of any invasive procedure is bound to create some anxiety—especially if it’s being done based on a suspicion there may be something seriously wrong with your lungs or airways—understanding that the bronchoscopy itself won’t hurt or put you in danger should help to ease your mind to some extent and allow you to focus on what you need to in regards to your condition.
3 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Andolfi, M., Potenza, R., Capozzi, R., Liparulo, V., Puma, F., and K. Yasufuku.The Role of Bronchoscopy in the Diagnosis of Early Lung Cancer: A Review. Journal of Thoracic Disease. 2016. 8(11):3329-3337. doi:10.21037/jtd.2016.11.81Khan, K., Nardelli, P., Jaegar, A. et al.Navigational Bronchoscopy for Early Lung Cancer: A Road to Therapy. Advances in Therapy. 2016. 33(4):580-96. doi:10.1007/s12325-016-0319-4.Lee, P. et al.Management of Complications From Diagnostic and Interventional Bronchoscopy. Respirology. 2009. 14(7):940-53. doi:10.1111/j.1440-1843.2009.01617.x.Additional ReadingHerth, F.Bronchoscopy/Endobronchial Ultrasound. Frontiers of Radiation Therapy and Oncology. 2010. 42:55-62. doi:10.1159/000262460.Lin, C., and F. Chung.Central Airway Tumors: Interventional Bronchoscopy in Diagnosis and Management. Journal of Thoracic Diseases.2016. 8(10):E1168-1176. doi:10.21037/jtd.2016.10.101.Medline Plus.Bronchoscopy. Jan 30, 2016.Merck Manual: Professional Version.Bronchoscopy. Oct 2016.
3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Andolfi, M., Potenza, R., Capozzi, R., Liparulo, V., Puma, F., and K. Yasufuku.The Role of Bronchoscopy in the Diagnosis of Early Lung Cancer: A Review. Journal of Thoracic Disease. 2016. 8(11):3329-3337. doi:10.21037/jtd.2016.11.81Khan, K., Nardelli, P., Jaegar, A. et al.Navigational Bronchoscopy for Early Lung Cancer: A Road to Therapy. Advances in Therapy. 2016. 33(4):580-96. doi:10.1007/s12325-016-0319-4.Lee, P. et al.Management of Complications From Diagnostic and Interventional Bronchoscopy. Respirology. 2009. 14(7):940-53. doi:10.1111/j.1440-1843.2009.01617.x.Additional ReadingHerth, F.Bronchoscopy/Endobronchial Ultrasound. Frontiers of Radiation Therapy and Oncology. 2010. 42:55-62. doi:10.1159/000262460.Lin, C., and F. Chung.Central Airway Tumors: Interventional Bronchoscopy in Diagnosis and Management. Journal of Thoracic Diseases.2016. 8(10):E1168-1176. doi:10.21037/jtd.2016.10.101.Medline Plus.Bronchoscopy. Jan 30, 2016.Merck Manual: Professional Version.Bronchoscopy. Oct 2016.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Andolfi, M., Potenza, R., Capozzi, R., Liparulo, V., Puma, F., and K. Yasufuku.The Role of Bronchoscopy in the Diagnosis of Early Lung Cancer: A Review. Journal of Thoracic Disease. 2016. 8(11):3329-3337. doi:10.21037/jtd.2016.11.81Khan, K., Nardelli, P., Jaegar, A. et al.Navigational Bronchoscopy for Early Lung Cancer: A Road to Therapy. Advances in Therapy. 2016. 33(4):580-96. doi:10.1007/s12325-016-0319-4.Lee, P. et al.Management of Complications From Diagnostic and Interventional Bronchoscopy. Respirology. 2009. 14(7):940-53. doi:10.1111/j.1440-1843.2009.01617.x.
Andolfi, M., Potenza, R., Capozzi, R., Liparulo, V., Puma, F., and K. Yasufuku.The Role of Bronchoscopy in the Diagnosis of Early Lung Cancer: A Review. Journal of Thoracic Disease. 2016. 8(11):3329-3337. doi:10.21037/jtd.2016.11.81
Khan, K., Nardelli, P., Jaegar, A. et al.Navigational Bronchoscopy for Early Lung Cancer: A Road to Therapy. Advances in Therapy. 2016. 33(4):580-96. doi:10.1007/s12325-016-0319-4.
Lee, P. et al.Management of Complications From Diagnostic and Interventional Bronchoscopy. Respirology. 2009. 14(7):940-53. doi:10.1111/j.1440-1843.2009.01617.x.
Herth, F.Bronchoscopy/Endobronchial Ultrasound. Frontiers of Radiation Therapy and Oncology. 2010. 42:55-62. doi:10.1159/000262460.Lin, C., and F. Chung.Central Airway Tumors: Interventional Bronchoscopy in Diagnosis and Management. Journal of Thoracic Diseases.2016. 8(10):E1168-1176. doi:10.21037/jtd.2016.10.101.Medline Plus.Bronchoscopy. Jan 30, 2016.Merck Manual: Professional Version.Bronchoscopy. Oct 2016.
Herth, F.Bronchoscopy/Endobronchial Ultrasound. Frontiers of Radiation Therapy and Oncology. 2010. 42:55-62. doi:10.1159/000262460.
Lin, C., and F. Chung.Central Airway Tumors: Interventional Bronchoscopy in Diagnosis and Management. Journal of Thoracic Diseases.2016. 8(10):E1168-1176. doi:10.21037/jtd.2016.10.101.
Medline Plus.Bronchoscopy. Jan 30, 2016.
Merck Manual: Professional Version.Bronchoscopy. Oct 2016.
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