Smarter Decisions,
Better Care

UpToDate synthesizes the most recent medical information into evidence-based practical recommendations clinicians trust to make the right point-of-care decisions.

  • Rigorous editorial process: Evidence-based treatment recommendations
  • World-Renowned physician authors: over 5,100 physician authors and editors around the globe
  • Innovative technology: integrates into the workflow; access from EMRs

Choose from the list below to learn more about subscriptions for a:


Subscribers log in here


Rigid bronchoscopy: Instrumentation

INTRODUCTION

Rigid bronchoscopy is a technique that visualizes the trachea and proximal bronchi. It is usually performed in the operating room under general anesthesia. Rigid bronchoscopy is most commonly used to manage patients who have obstruction of either their trachea or a proximal bronchus, since the rigid bronchoscope’s large lumen facilitates suctioning and the removal of debris, or for interventional procedures such as insertion of airway stents [1,2]. (See "Diagnosis and management of central airway obstruction" and "Airway stents".)

Rigid bronchoscopes, equipment for visualization, and accessory instruments are reviewed here. Techniques of rigid bronchoscopic intubation are described separately. (See "Rigid bronchoscopy: Intubation techniques".)

RIGID BRONCHOSCOPES

The rigid bronchoscope is also known as an open tube bronchoscope, open tube, straight bronchoscope, or ventilating bronchoscope. It is a rigid, straight, hollow metal tube that is available in several sizes. Its purpose is to provide access to the airways.

The external diameter of a rigid bronchoscope varies from 2 to 14 mm, wall thickness ranges from 2 to 3 mm, and length varies from a very short tube (for pediatric cases) to a long or extra long tube (for adults). Tubes with an extra large diameter have been developed for exceptional cases of tracheobronchomalacia, but they are not readily available.

Most rigid bronchoscopes are the same diameter from the proximal to the distal end, although some have a beveled or tapered tip to lift the epiglottis during intubation. (See "Rigid bronchoscopy: Intubation techniques".) Variations in the tip design also facilitate the dilation of airway strictures. Most rigid bronchoscopes are round when visualized in cross-section, with external side ports that permit the introduction of suction catheters, laser fibers, and ventilation (picture 1). A few are almost oval. A small internal channel exists in some rigid bronchoscopes, through which the rigid telescope passes. Others are simply an empty tube. Some rigid bronchoscopes can analyze exhaled gases.

      

Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Sep 2014. | This topic last updated: Oct 3, 2013.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2014 UpToDate, Inc.