Bronchoscopy is a procedure that allows the physician to see the larynx (voice box), trachea (windpipe), and the large and small air passages in the lungs (bronchi and bronchioles). This procedure is performed by a respirologist (lung doctor) usually at the request of your hematologist. This exam may be done to:
Collect a tissue or cell sample (biopsy)
Collect a fluid or sputum sample
Locate areas that may be bleeding
Remove foreign bodies
Help diagnose infections, or pulmonary edema (too much fluid in the lung tissue)
Diagnose lung problems of undetermined cause.
The bronchoscope is a flexible, small tube. It contains fibres that carry light down the tube and project a picture up the tube. Another open channel is used to take biopsies. A small brush may be used to brush the tissue walls to collect cells or secretions. An instrument called biopsy forceps may be used to pinch off a tiny bit of tissue. This channel can also be used for suctioning, oxygen, and anaesthetic.
You must not eat or drink anything for at least eight hours before the exam. Dentures must be removed before starting the procedure. Before the procedure, you may be given something to help you relax and to decrease secretions in the lungs. This will make your mouth feel dry.
The Procedure - What to Expect
The exam can be done with you lying on your back or sitting upright. A local anaesthetic and an intravenous sedative are usually used. Your mouth, throat, and tongue will be sprayed with the local anaesthetic. This will stop you from gagging. The spray works in 2-3 minutes. It may taste bitter and make the tongue and throat feel swollen. An anaesthetic jelly is used to help the bronchoscope insert more easily, and to prevent coughing or gagging.
You may feel groggy from the sedative. Your throat may be sore and your voice may be hoarse. These symptoms will go away.
You will not be allowed to eat or drink anything until the gag reflex returns. This may take several hours. The nurse will check carefully to make sure you can swallow without any problems. Back in the hospital room, you should lie on your side with the head of the bed raised. The nurse will check to make sure you don't have any breathing or other problems.
The procedure often takes 1 to 1 ½ hours. If your white blood cell count is low, you will be asked to wear a mask while out of your room.