Bronchoscopic Foreign Body Retrieval

Bronchoscopic foreign body retrieval

Bronchoscopic foreign body retrieval is a procedure that is done minimally invasively to find and remove those objects which have been accidentally inhaled in the airways. It is usually done on children but it is also carried out in adults. The timely removal of the foreign body is relevant to avoid airway blockage, pulmonary infection or chronic complications.

Foreign body removal bronchoscopy

The procedure involves the insertion of the foreign body removal bronchoscopy, which is minimally invasive, to identify and remove inhaled objects that have been introduced into the airway accidentally. It is the gold standard of treatment of airway foreign bodies both in children and adults. Early clearance will help to avoid airway blockage, infection and permanent lung impairment.

This is a procedure used to remove a foreign body in the bronchi.

Preparation

• Clinical assessment and radiographic analysis (X-ray or CT) to determine the object.
• Fasting for 6–8 hours.
• General anaesthesia in children; general or conscious sedation in adults.

Bronchoscopy Types Used

Rigid bronchoscopy

• Preferred in children.
• Gives better airway control and more working channel tools.

Flexible bronchoscopy

• Common in adults.
• Applicable to smaller foreign bodies or those that is distally trapped.

Procedure

• The bronchoscope gets into the trachea and through the mouth.
• The foreign body is located by thoroughly studying the airway.
• Grasping forceps, baskets, alligator forceps, suction catheters or magnets (in the case of metallic objects) are inserted as retrieval instruments.
• The assessment is by holding on to the object and dragging it out of the bronchoscope.
• The airway is re-examined as to injury, swelling, or residual material.
• Suction or lavage is done to clear secretions in case of need.

Bronchoscopy Recovery in the Removal of Foreign Bodies

• Within minutes to an hour, patients get out of anaesthesia.
• Mild cough, sore throat, or hoarseness can be experienced 1-2 days.
• Improvement in breathing normally ensues after removal.
• Chest X-ray can be performed after the procedure.
• Unless there are complications, normal diet and activity may resume on the same day.
• Children might be in need of brief stay in the hospital.

Flexible bronchoscopy foreign body

Flexible bronchoscopy is a less invasive technique that is employed to identify and remove foreign bodies that are of small size or are distally trapped in the airways. Although rigid bronchoscopy is the preferred choice in children rigid bronchoscopy, flexible bronchoscopy is more effective in adults, stable patients and use in objects deep in the bronchial tree.

Flexible Bronchoscopy Foreign Body Removal Procedure:

Preparation

• X-ray or CT scan of the chest to find the object.
• Fasting for 6–8 hours.
• Depending on the condition of the patient, sedation or general anaesthesia.
• Oxygen measurement and airways evaluation.

Procedure

• A fine bimanual bronchoscope is passed into the mouth or nose.
• The bronchoscope is pushed to the trachea and bronchi.
• The camera is used to view the foreign body.

The bronchoscope passes its retrieval tools through the working channel of the bronchoscope, including:

• Alligator forceps
• Grasping forceps
• Wire baskets
• Cryoprobes (of various objects)
• Suction catheters
• The scope is used to hold the object carefully and take it away.
• Airway is observed to check whether it is injured or not or to check the presence of residual particles.

Flexible Bronchoscopy Foreign Body Recovery 

• Sedation may be quickly turned off and usually takes 30–60 minutes to resolve.
• 24h hours of Hoarseness, sore throat or mild cough may be felt. 
• It can resume to normal activity during the same day.
• Follow up X-ray of the chest can be done.
• In case of infection, antibiotics or bronchodilators can be ordered.

Best hospital for bronchoscopic foreign body retrieval India

• Artemis Hospital, Gurgaon
• Medanta-The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Max Hospital, Saket

Conclusion

The most popular, least invasive and gold-standard treatment of the inhaled object is bronchoscopic foreign body removal in both children and adults. The operation has a good visualization, high success rates, and quick recovery whether done in rigid bronchoscopy - which is ideal in large, sharp, or proximal foreign bodies and especially in children, or done in flexible bronchoscopy which is ideal in small or distally lodged objects. The intervention is essential which avoids complications like airway obstruction, infection or lung damage. The removal of foreign bodies can be performed safely with more than 95 99 percent success with the help of modern bronchoscopic equipment and skilled personnel regardless of the need to resort to surgery. The process is highly tolerated, and side effects are mild and interim, and severe complications are an infrequent occurrence.

Bronchoscopic foreign body retrieval India GetWellGo

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FAQ

1. Is the procedure painful?

• No. The procedure is carried out under general anaesthesia (especially in case of children) or sedation in adult but it is painless for the patient.

2. How long does the procedure take?

• Most operations take about 15-45 minutes, depending on the size and position of the foreign body. 

3. What are the typical objects that are taken away?

• Nuts, seeds, food particles, toy parts, beads, pins and small metal objects, and also materials for dental use. 

4. What if a foreign body gets inhaled? 

• The common symptoms are sudden coughing, choking, wheezing, noisy breathing, difficulty breathing, or persistent cough. Cases of pneumonia may be triggered by old age.

5. Is the hospitalization necessary?

• A majority of the cases are day-care procedures. Unless there are complications and a long duration of observation is required, patients are discharged the same day.

6. What is the success rate?

• The rate of successful bronchoscopic removal of foreign bodies is >95-99%.

7. What happens if the object is not removed with bronchoscopy?

• In the exception cases, a surgery (thoracoscopy or thoracotomy) could be required to take out the deeply seated or complicated bodies.

8. Is flexible bronchoscopy a safe procedure for removal of foreign bodies? 

• It is safe and effective with small or distal objects, mostly in adults. In case of failure of removal, rigid bronchoscopy is done.

9. Do patients require postoperative antibiotics?

• Not always. The administration of antibiotics is based on the presence of infection or severe airway swelling.

10. Is it safe to make children undergo this procedure?

• Yes. The procedure of rigid bronchoscopy under general anaesthesia is the norm and is highly safe in experienced hands of trained specialists in airway in children.

11. In what time should a foreign body be removed?

• An early withdrawal minimizes the chances of airway blockage, pneumonia and even lung collapse.