Bronchoscopy & Endobronchial Ultrasound (EBUS)

What is bronchoscopy?
Why do I need a bronchoscopy?  
What are the risks of having a bronchoscopy?
How do I prepare for a bronchoscopy?
What happens during a bronchoscopy?
What happens after a bronchoscopy?

A bronchoscopy is a procedure that allows your doctor to look at your airways and lungs.

What is a bronchoscopy?

A bronchoscopy is a procedure that allows your doctor to take a detailed look at your airways and lungs. Using an instrument called a bronchoscope, your doctor can examine all of the structures that make up your respiratory system, including your:

  • Larynx
  • The smaller airways of your lungs, including the bronchi and bronchioles
  • Trachea.

Why do I need a bronchoscopy?

A bronchoscopy can investigate symptoms such as:

  • An abnormal scan result
  • Coughing up blood
  • Unusual breathing.

A bronchoscopy can also help to diagnose:

  • A tumour
  • Lung disease
  • Lung infection.

As well as diagnosing and investigating lung symptoms and diseases, a bronchoscopy can treat some airway problems, including:

  • Lung cancer
  • Removal of a foreign object
  • Removal of fluid or mucus in the lungs.

If you’ve had a lung transplant, you will need to have bronchoscopies regularly. 

Below, you can watch a short video from one of our doctors explaining more about bronchoscopies.

 

Below, you can watch an animation explaining what happens during a bronchoscopy.

What are the risks of having a bronchoscopy?

For most people, a bronchoscopy is a safe procedure. But, as with any test or procedure, there are some small risks, including:

  • Bleeding where the bronchoscope was inserted
  • Difficulty breathing after the procedure
  • Infection after the procedure
  • Low blood oxygen level during the test.

A collapsed lung is an extremely rare risk and can be treated immediately by your doctor.

How do I prepare for a bronchoscopy?

To prepare for your bronchoscopy, you will need to fast for a minimum of six hours beforehand. You can drink water or other clear fluids until two hours beforehand.

If you take medications, talk to your doctor about what’s safe to keep taking. You may need to temporarily stop taking certain types of pain relief, diabetes or blood thinning medications.

Make sure you bring a family member or friend to your bronchoscopy appointment. You will need someone to drive you home afterwards or help you arrange separate transportation.

What happens during a bronchoscopy?

Your bronchoscopy will take place in the operating theatre or intensive care unit of a hospital. During the procedure:

  • A local anaesthetic spray is applied to your throat
  • You are awake, but will feel relaxed and drowsy
  • Your doctor will insert the bronchoscope into your mouth
  • The bronchoscope passes from your mouth down to your throat until it reaches your bronchi (the airways in your lungs)
  • Your doctor will view your airways and take photos or videos of them
  • Your doctor can also take a sample of your tissue, which is known as a biopsy
  • The bronchoscope will be in your airways for around 20 minutes
  • You will be able to breathe during the procedure.

LUNG BIOPSY

If your doctor wants to take a tissue sample from your lungs, tiny brushes may be attached to the bronchoscope to help collect samples.

BRONCHIAL WASHOUT

Your doctor may also use a process called ‘bronchial washing’ to collect samples. In this process, a mild salt solution is washed over the surface of the airways. The salt solution collects cells which can then be studied under a microscope. Increasingly, newer forms of testing can help to give a more detailed picture of your lungs and airways.

Some of the emerging procedures include: 

  • Endobronchial ultrasound (EBUS) – an ultrasound probe is attached to a bronchoscope to view the airways
  • Fluorescence bronchoscopy – fluorescent light attached to the bronchoscope shows the inside of the lungs
  • Virtual bronchoscopy – a CT scan of your airways.

What happens after a bronchoscopy?

After your bronchoscopy, you will need to stay at the hospital until the local anaesthetic wears off. You won’t be able to eat or drink until your throat is no longer numb. After three hours, your doctor will ask you to take a ‘sip test’ to check that your gag reflex has completely returned. This test confirms that it is safe for you to start eating and drinking again.

You won’t be able to drive yourself home after your procedure. Make sure a friend or family member can drive you home or help you arrange transport. Shortly after your procedure, your doctor will contact you to discuss the results of your tests, make a diagnosis and put a care plan in place.

For a few days after your procedure, your throat might feel sore, dry, hoarse or scratchy. This effect is temporary, and it should go away without medication. But, if you’re still not feeling quite right after a few days, call your doctor.

You should also call your doctor if you:

  • Are coughing up blood
  • Are having trouble breathing
  • Have a fever.

Remember – if, at any time, you have questions about your procedure or recovery, contact your doctor.