Rigid bronchoscopy is a procedure that helps doctors diagnose and manage several conditions that affect the airways. It involves inserting a metal tube with a light and camera into a person’s throat and down their windpipe.
Doctors may use rigid bronchoscopy to remove an airway obstruction, blood clot, or mucus.
The procedure can cause complications, such as trauma to the teeth or low oxygen levels. If a person experiences any alarming symptoms — including chest pain or shortness of breath — following the procedure, they will need to go to an emergency room.
This article examines rigid bronchoscopy, including its uses, complications, and what to expect before, during, and after the procedure. It also discusses when a person may need to call a doctor.
Rigid bronchoscopy is a procedure that involves the use of a thin, hollow metal tube called a bronchoscope.
The tube has an attached light and camera. A doctor gently inserts the bronchoscope down the throat and through the windpipe, also called the trachea, to assess the airways.
A person having the procedure usually receives anesthesia, which is a medication that puts an individual in an unconscious state. Rigid bronchoscopy has both diagnostic and therapeutic uses.
One of the main uses of rigid bronchoscopy is removing a foreign object.
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However, the procedure is only useful when the foreign object lodges in the bronchus, one of the two main air passageways connecting to the trachea. A surgical incision into the chest wall is necessary for removing objects lodged in a smaller bronchus.
Other therapeutic uses of rigid bronchoscopy
The procedure can also help manage massive hemoptysis, which refers to coughing up a lot of blood.
Anecdotal reports indicate that other uses of bronchoscopy may include:
- decreasing the size of a tumor
- placing a hollow tube called a stent in an airway to keep it open
- performing a biopsy, which involves removing a tissue sample to examine under a microscope
Learn more about bronchoscopy.
Generally, the complication rate is low with rigid bronchoscopy.
Mechanical complications occur due to injury from direct contact with body parts during insertion and movement of the tube.
The most common mechanical complications of rigid bronchoscopy include:
- trauma to the teeth, throat, or vocal cords
- a pneumothorax, which is a collapsed lung due to air collecting between the lungs and chest wall
- laryngospasms, which are vocal cord spasms that can make breathing and speaking difficult
Systemic complications are general effects involving the body.
With rigid bronchoscopy, these may include:
- vasovagal syncope, which is fainting
- hypercarbia, which refers to an increase in carbon dioxide in the blood
- hypoxemia, where a person has low blood oxygen levels
- an arrhythmia, which is an irregular heart rate
- postprocedural respiratory failure, a life threatening condition where there is too little oxygen or too much carbon dioxide in the blood
- side effects of general anesthesia, such as:
Mechanical or systemic complications can have serious consequences. However, rigid bronchoscopy is generally safe.
A person will need to ask their doctor which medications they should refrain from taking before the procedure and for how long.
For example, a doctor may recommend stopping blood thinners — including aspirin — for
People will also need to follow their doctor’s instructions regarding how long to fast before the procedure. This may involve not eating or drinking after midnight the night before.
Other preparations include arranging a ride home, as no one should attempt to drive until the effects of the anesthesia wear off completely.
Doctors advise people to do the following on the day of the rigid bronchoscopy:
- wear loose, comfortable clothing
- avoid using fragrances, makeup, deodorant, or lotions
- avoid wearing contact lenses or jewelry
- remove dentures, hearing aids, and prosthetic devices before the procedure
Generally, a person will speak with a nurse, an anesthesiologist, and their doctor before the procedure starts.
The healthcare team will help the person get on an examination table. The team will monitor the person’s blood pressure, heart rate, and breathing.
The person will receive anesthesia through an intravenous (IV) line. After they are unconscious, the procedure will begin.
It usually takes 30–45 minutes to complete but sometimes takes longer.
Individuals can expect the following to take place after the procedure:
- Immediately afterward, a nurse will monitor the person’s oxygen level, blood pressure, heart rate, and temperature.
- A nurse will remove their IV.
- The doctor will talk with the person to explain the findings.
- The doctor or nurse will provide instructions about appropriate activities in the following hours.
If a doctor took a biopsy or conducted other tests during the procedure, the person will need to follow up with them to get the results.
These may be available within 2–4 days, but some results may take a week or longer.
The following symptoms may indicate a serious complication:
- bleeding that worsens or persists
- chest pain
- shortness of breath
- signs of infection, such as:
It is important for anyone who experiences these symptoms after this procedure to contact a healthcare professional or the person in charge of their care.
In cases where a person experiences chest pain or shortness of breath, they will need to go to the emergency room.
A flexible bronchoscope is a bendable tube with a fiberoptic light source and camera. This contrasts with the firm tube of the rigid type.
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Rigid bronchoscopy involves inserting a thin metal tube called a bronchoscope into the throat and trachea. Doctors use it to diagnose or treat several airway conditions.
This procedure has the potential to cause mechanical complications, such as bleeding or trauma to the teeth. It may also lead to systemic complications, including low levels of oxygen and high levels of carbon dioxide in the blood.
To prepare, a person will need to follow a doctor’s instructions regarding what medications to avoid taking and how long to abstain from food and beverages beforehand.
Because some complications are very serious, people need to call a doctor if they have any alarming symptoms after the procedure, such as shortness of breath or chest pain.