Diagnostic Bronchoscopy

Diagnostic bronchoscopy

Diagnostic bronchoscopy is an endoscopic procedure that is applied to observe the breathing airways. It is used in detecting abnormalities like inflammation, infection, tumor, bleeding or obstruction of airways. Tissues or other fluids can also be sampled and put under laboratory examination using the procedure.

Applications of Diagnostic Bronchoscopy

Bronchoscopy is conducted to establish:

• Persistent cough

• Unexplained wheezing
• Pneumonia, fungal infections, lung infections (TB).
• Abnormal CT scan, lung tumors.
• Hemoptysis 
• Airway strictures or obstruction. 
• Interstitial lung disease
• Evaluation of Lymph Node 

Bronchoscopy (Diagnostic): Flexible vs.Rigid 

Flexible Bronchoscopy

• Most commonly used
• Consciously sedated.
• Intraprostatic visualization and sampling of airways.

Rigid Bronchoscopy (diagnosis not common)

• Robotic surgery was done under general anaesthesia.
• Indicated as the airway is blocked or likely to bleed heavily.
• Allows larger biopsies

Indications of Diagnostic Bronchoscopy

• Lung shadow in the X-ray/CT that is not explained.
• Persistent pulmonary symptoms.
• Suspected lung cancer
• Suspected infections
• Foreign body suspicion
• The lung tumors (staged by EBUS) were also staged.

Diagnostic bronchoscopy procedure

Diagnostic bronchoscopy is a non-invasive type of endoscopy procedure which enables physicians to examine airways and sample items to identify diseases in the lungs. A flexible bronchoscope under local anaesthesia and sedation is normally used to do the procedure.

Preparation before the Procedure

Fasting

• Not to eat or drink 6-8 hours in advance of the procedure.

Medical Review

Your doctor will consider:

• Medications (especially blood thinners like aspirin, clopidogrel, warfarin, etc.) 
• Allergies
• Lung and heart conditions

Tests before procedure

• Chest X-ray or CT scan
• Blood tests (coagulation tests included)

Sedation & Anaesthesia

You will receive:

• Local anaesthetic spray of the throat.
• Sedation (mild to moderate) to make you calm down.
• Delivery of medicine by IV cannula sometimes is needed.

During the Procedure

Positioning

• You are lying on procedure table which is normally semi-reclined.

Introduction of the Bronchoscope

A flexible bronchoscope either through the mouth or nose is inserted through the:

• Throat
• Voice box (larynx)
• Windpipe 
• Bronchi 
• Airway Examination

The airway lining is inspected by the doctor regarding:

• Inflammation
• Tumors
• Blockages
• Infection
• Bleeding
• Live images are relayed through the camera onto a monitor.

Sampling Techniques

The doctor might also have to perform:

• Bronchoalveolar Lavage
• The airway is injected and suctioned using sterile saline.
• Diagnoses Infections and inflammatory diseases.

Endobronchial Biopsy

• Abnormal areas within the airway are sampled with small tissues.

Transbronchial Lung Biopsy

• Sample of Tissues in deeper sections of the lungs.
• Applied in interstitial lung diseases, sarcoidosis etc.

Brushings

• Suspicious cells are gathered using a small brush.

Needle Aspiration (TBNA)

• Lymph node or mass below the airway walls are sampled using a needle.

Duration

• The whole process of it usually lasts between 20 and 40 minutes.

After the Procedure

Monitoring

• It will take 1-2 hours to note when the sedation has clear-cut.

Eating & Drinking

• Wait until numbness in throat subsides (typically 1-2 hours)
• Start with sips of water

Discharge

• Majority of the patients leave home the same day.

Diagnostic bronchoscopy recovery

The post diagnostic bronchoscopy recovery is generally rapid due to the minimal invasive nature of the procedure and the usage of mild sedation. Most patients return to their home and feel normal just a couple hours later.

Intense Recovery (First 1-2 Hours) 

Observation

• You will spend some time in an area of recovery until the sedative wears off.
• The most important of these is the regular checking of vital signs (heart rate, oxygen, blood pressure).

Throat Numbness

• Aesthetic spray on the throat causes numbness in the throat, which lasts 1-2 hours.
• Choking can occur because once you have numbness you should not eat or drink until this feeling passes.

Sedation Effects

• You will either be sleepy, dizzy, or slightly disoriented.
• You should get somebody to take you home.

First 24 Hours (After Returning Home)

Eating and Drinking

• Once the numbness fades start with sips of water.
• Advance to soft and light foods in the first few hours.

Activity Restrictions

• Now rest the rest of the day.
• No driving, no drinking, no heavy labor for 24 hours.
• Smoking should also be avoided as it can cause irritation to the airway. 

Diagnostic bronchoscopy complications

Diagnostic bronchoscopy is an invasive procedure that is generally considered safe, although all medical procedures have potential risks and complications. Most of the complications are rare and mild to moderate, but severe events may occur. 

Common, Mild Complications

• Sore throat or hoarseness
• Coughing or mild bleeding
• Temporary dizziness or drowsiness
• Mild fever

Moderate Complications

• Bronchospasm
• Infection
• Prolonged bleeding

Uncommon, High-Risk Complications

• Pneumothorax (lung collapse)
• Fatal bleeding (haemorrhage)
• Anaphylactic reactions 
• Respiratory failure

Best hospital for diagnostic bronchoscopy India

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

Conclusion

Diagnostic bronchoscopy is a safe, minimum invasive and a very effective method of assessing the airways and detecting a broad variety of lung diseases, including lung infections, tumors, persistent cough, hemoptysis, and interstitial lung diseases. The physicians are able to directly see the trachea and bronchi using a flexible bronchoscope and can collect tissue or fluid samples, and have vital diagnostic data, which cannot be obtained using imaging alone. Most patients are usually able to resume normal lives after a few hours and recovery is quick. As much as mild complications such as sore throat or cough are prevalent, severe complications such as pneumothorax or severe bleeding are uncommon. Safety is guaranteed by careful patient screening and selection, proficiency and post procedure follow-up.

Diagnostic bronchoscopy procedure India GetWellGo

GetWellGo is regarded as a leading supplier of healthcare services. We help our foreign clients choose the best treatment locations that suit their needs both financially and medically.

We offer:

• Complete transparency
• Fair costs.
• 24 hour availability.
• Medical E-visas
• Online consultation from recognized Indian experts.
• Assistance in selecting India's top hospitals for diagnostic bronchoscopy procedure.
• Expert pulmonologist/thoracic surgeon with a strong track record of success
• Assistance during and after the course of treatment.
• Language Support
• Travel and Accommodation Services
• Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
• Local SIM Cards
• Currency Exchange
• Arranging Patient’s local food

FAQ

1. Is bronchoscopy painful?

• No. It’s nice to be able to work comfortably under local anaesthetic and light sedation. You may feel mild throbbing in the throat or a slight gagging.

2. Will I be sleeping during the procedure?

• You will be usually not unconsciously but under trance. In some situations, general anaesthesia can be adopted.

3. Is it possible to eat or drink following bronchoscopy?

• Not until the throat numbness subsides, typically 1 -2 hours. Begin with water, and then light food.

4. Who can perform a diagnostic bronchoscopy?

• Experienced endoscopic pulmonologist / thoracic surgeon

5. Can patients with lung disease or elderly patients safely have a bronchoscopy? 

• Yes, although special care is observed in those patients who are aged, have advanced lung or heart disease, or have a bleeding disorder.