Bronchoscopy

A bronchoscopy is a minimally invasive procedure that allows your doctor to see your airways and lungs. A thin tube called a bronchoscope is gently passed through your mouth or nose, down your throat, and into your lungs. Your doctor might use a robot that helps guide the scope, a technique known as robotic-assisted bronchoscopy. The procedure can also be used to take samples for testing or treat lung conditions.

Penn Medicine’s skilled physicians have extensive experience performing bronchoscopies. They use advanced technology to precisely guide the scope to the part of the lung that needs to be evaluated or treated. As a less invasive procedure compared with surgery, you benefit from a faster diagnosis and effective therapies that help put you on the road to recovery.

Most often, a bronchoscopy is done if you have signs or symptoms of lung disease, like:

• A cough that doesn’t go away
• Shortness of breath or low oxygen levels
• A lung infection or inflammation
• An abnormal chest x-ray or computed tomography (CT) scan

A bronchoscopy is used to diagnose the cause of your symptoms, sometimes by taking samples of fluid or tissue, known as a biopsy. This procedure can also remove mucus or a tumor, administer medicines, or place an airway stent that opens your breathing passage. If you have bleeding or a collapsed lung, called pneumothorax, this procedure can treat those conditions. In some cases, your doctor may use a bronchoscope with an ultrasound probe, known as an endobronchial ultrasound (EBUS), to check your lung or lymph nodes for disease.

Talk to your health care team about how to prepare for your bronchoscopy. You might need a CT scan before the procedure. Several days before your appointment, you’ll need to stop taking certain medications, including drugs that thin your blood. You’ll also need to fast before your appointment and arrange for someone to drive you home afterward.

On the day of your bronchoscopy:

• You’ll be given medicine to help you relax, known as sedation, and numbing spray or gel in your mouth or nose. Or you might be given general anesthesia, which will put you to sleep.
• Monitors will be placed to track your blood pressure, heart rate, and oxygen level, and you may be given oxygen through a mask or tube.
• The scope will be inserted, making you cough briefly. Then your doctor will slowly advance the scope to your lungs. A tiny lighted camera on the scope creates pictures on a video screen. Often a flexible bronchoscope is used, but a rigid one may be required in certain situations.
• Once the scope is in place, your doctor might use a saline solution to clean your lungs.
• If you’re having an endobronchial ultrasound, sound waves will create images for evaluation.
• Tools passed through the bronchoscope allow your doctor to take small samples of tissue, fluids, or other materials, if needed.
• Depending on the reason for your bronchoscopy, your doctor might place a stent, remove a tumor, or perform other procedures.
• The scope is then removed.

You’ll be monitored while your sedation or general anesthesia wears off. It may take an hour or longer for throat numbing medication to stop working, and you can’t eat or drink until your health care team says it’s OK. You’ll be able to go home the same day.

It’s common to have a sore throat, cough, and hoarse voice for 24 hours after the procedure. You may also have a mild fever and minor bleeding if you had a biopsy. Let your doctor know if you’re concerned about any bronchoscopy side effects.

Pulmonary experts, thoracic surgeons, and other specialists have extensive experience performing bronchoscopies at Penn Medicine. Our interventional pulmonology program, where physicians perform bronchoscopies and other minimally invasive procedures, is one of the oldest and most advanced in the United States. Part of what sets us apart include our:

• Use of the latest technology to perform procedures like endobronchial ultrasound and navigational bronchoscopy
• Experience providing ablative bronchoscopic therapies, including laser bronchoscopy, to hundreds of people a year
• Innovative procedures, like transbronchial cryobiopsy and combining robotic-assisted bronchoscopy with cone-beam CT
• Reputation as one of the highest volume centers in the country performing endobronchial stenting

Our experts also work closely with specialists from a variety of disciplines, including allergy, critical care, medical and radiation oncology, transplant, and ear, nose, and throat, so you receive continuous and complete care.