During this examination a thin fibreoptic tube is passed into the breathing tubes. There is no need to be anxious about this being painful or uncomfortable. The procedure is done using local anaesthetic, which eliminates sensation from the tissues in the throat and breathing tubes. Sedation is also used, and I always ask the people having the procedure to indicate if they need more. I want this test to be free of discomfort.
I usually pass the 'scope through the mouth, then down through the voice box (larynx) into the breathing tubes. Occasionally I pass the 'scope through the nose, but I try to avoid this as the nose can be sensitive.
The trachea divides inside the chest into a right and a left branch, and more branches divide off these, allowing air to go to the various parts of the right lung and the left lung. I always inspect both sides carefully. If tissue that looks unusual is seen, biopsies are taken with a fine set of forceps which fit inside the bronchoscope. Washings are often taken, and they are sent for cytology and/or culture for various organisms, when appropriate.
Before the bronchoscopy it is necessary to fast (nothing to eat or drink) for 4 hours.
After the procedure has finished, drinks and food are withheld for about an hour to make sure the local anaesthetic has worn off. Eating or drinking before the anaesthetic has worn off can result in food or fluids going down into the breathing tubes instead of the swallowing tube (or oesophagus). People usually leave about 1-1.5 hours after the procedure. Someone else should drive as the sedation can impair judgement for up to 6-8 hours, depending on how much was required.
The bronchoscopy procedure is performed by a doctor (myself). Nursing staff help before, during and afterwards. Oxygen is given during the procedure and the oxygen level in the blood and heart rate are monitored. Results of the bronchoscopy are usually discussed at an appointment with me about a week after the procedure.