Flexible bronchoscopy in adults: Overview
- Shaheen Islam, MD, MPH, FCCP
Shaheen Islam, MD, MPH, FCCP
- Ohio State University Medical Center
Bronchoscopy is an endoscopic procedure that visualizes the tracheobronchial tree by placing an optical instrument inside the airways. The value of bronchoscopy has grown in its diagnostic and therapeutic capacity such that the clinician needs to be aware of the available technology and the associated clinical applications.
An overview of flexible bronchoscopy and accessory procedures that can be performed during flexible bronchoscopy are reviewed here. The procedure, indications, contraindications, and complications of flexible bronchoscopy are described separately. (See "Flexible bronchoscopy in adults: Indications and contraindications".)
TYPES OF BRONCHOSCOPY
The main types of bronchoscopy are compared in the table (table 1).
●Flexible bronchoscopy – Flexible bronchoscopy is also known as standard white light bronchoscopy. It is typically performed using conscious sedation and is a smaller more flexible piece of equipment that permits access to the lower airways such as the third order of bronchi (figure 1). Consequently, it is more widely used than rigid bronchoscopy for both diagnostic and therapeutic procedures. (See 'Flexible bronchoscopy' below.)
●Rigid bronchoscopy – Rigid bronchoscopy also uses a white light source to visualize the airways. However, compared to flexible bronchoscopy, it is a larger, more rigid piece of equipment that can only access the proximal airways. It requires general anesthesia and is usually used for interventional procedures for which flexible bronchoscopy cannot be performed. (See 'Rigid bronchoscopy' below.)
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- TYPES OF BRONCHOSCOPY
- Flexible bronchoscopy
- - Traditional white light bronchoscopy
- - Endobronchial ultrasound (EBUS)
- - Navigation bronchoscopy (NB)
- - Ultrathin bronchoscopy
- - Confocal bronchoscopy
- - Fluorescence bronchoscopy
- Rigid bronchoscopy
- Virtual bronchoscopy
- INDICATIONS AND CONTRAINDICATIONS
- EQUIPMENT AND PROCEDURE
- - Bronchoscope
- - Light source
- - Image processor
- INFECTION AND RADIATION ISSUES
- Infection control
- - Health care workers
- - Cleaning the bronchoscope
- Radiation control
- TRAINING AND COMPETENCY
- SUMMARY AND RECOMMENDATIONS