Bronchoscopy is performed to examine the airways inside the lungs with a small camera on the end of a thin, flexible tube. Bronchoscopy may provide useful information in a number of clinical situations and can be safely performed in an outpatient setting. Provided that patients are carefully selected, risks are minimal.

The Department of Respiratory Medicine performs routine flexible bronchoscopy twice weekly, on Wednesday and Friday afternoons. Emergency procedures can be performed at other times.

How is bronchoscopy performed?

There is no general anaesthetic. The procedure involves light sedation for patient comfort. A small-bore bronchoscope is passed through the mouth into the airways (breathing tubes), so that the airways can be directly observed. It is then possible to take tissue biopsies from within the airways or to introduce and retrieve saline (salty water) as appropriate. In selected cases, it may be appropriate to take biopsies from the lung tissue at the edge of the lung (transbronchial biopsies). The entire procedure is relatively brief, taking between five and 30 minutes. For most people the procedure is not uncomfortable and many do not even have any memory of it. In some cases the bronchoscopy may make people feel like coughing and this can be uncomfortable, however this sensation only lasts briefly.

Side Effects

The procedure is safe and without side effects in most cases.

In standard procedures there is very little risk of significant complications although occasionally patients may:

• cough blood afterwards
• develop breathlessness due to the procedure (low oxygen levels)
• develop asthma-type symptoms. If you have asthma, you should inform staff prior to the procedure so that medications can be given beforehand to prevent asthma symptoms.

In procedures in which a "transbronchial biopsy" is performed, there is a higher risk of complications, including:

• bleeding into the airways—this usually settles without problems
• pneumothorax (lung "puncture")—may require a chest tube being placed through the chest wall to relieve the lung puncture and admission to hospital. This occurs in up to 5% of patients having transbronchial biopsies
• death, however, the reported risk is between one in 1000 and one in 5000.

Special Instructions for Before and After the Bronchoscopy

Patients who are taking anti-inflammatory medications (for arthritis or muscle pains, such as voltaren, ibuprofen, etc) or aspirin should cease such medications for five to seven days before the procedure in most cases. You should discuss this with your doctor. If you are taking Warfarin, special arrangements will need to be made with your doctor before the procedure.

Patients should not eat for six hours or drink for four hours before the procedure. As bronchoscopies are generally performed at Mater between 1.30 pm and 4 pm, this usually means that you should not eat or drink after approximately 7 am on the day of the procedure.

You will be unable to drive a car (or heavy machinery) for 24 hours after the procedure due to the sedation given to you, therefore you will need to have someone available to pick you up and care for you for 24 hours.

In the 12 hours after the procedure you may:

• have sore throat or hoarse voice
• cough a small amount of blood—if this does not settle down within 24 hours or is more than three tablespoons, you should contact the doctor or hospital
• develop a fever—if this doesn't settle within 24 hours, contact the doctor or hospital.

Results From the Bronchoscopy

Results from the bronchoscopy will generally take three to four days to become available, so an appointment should be made for you for the week following the procedure to discuss these results.

If you have any questions related to the procedure do not hesitate to contact the doctor caring for you.

Contact

Endoscopy Unit
Level 5, Mater Adult Hospital
Phone: +61 7 3163 8183