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Bronchoscopy

Direct visualization of the airways and sampling using a thin camera-equipped instrument.

Diagnostic procedure in which the trachea and bronchi are examined using a flexible or rigid bronchoscope advanced through the nose or mouth, with the option to perform bronchoalveolar lavage (BAL) and biopsy.

Indication

  • Unexplained chronic cough or coughing up blood (hemoptysis)
  • Suspicious mass or nodule detected on chest X-ray or CT
  • Biopsy for the diagnosis and staging of lung cancer
  • Recurrent or treatment-resistant pneumonia
  • Suspected foreign body aspiration (especially in children)
  • Bronchoalveolar lavage (BAL) in interstitial lung diseases
  • Microbiological sampling in tuberculosis and atypical infections

Preparation

  • Fasting for 6-8 hours before the procedure
  • Discontinuation of blood thinners with physician approval
  • Pre-procedure blood tests and ECG
  • Removal of dental prostheses
  • Having an accompanying person available (driving is not allowed due to sedation)

How it's performed

  1. The patient is placed in a supine or semi-sitting position, and an IV line is established
  2. Local anesthetic spray is applied to the nose and throat; intravenous sedation is administered if needed
  3. A flexible bronchoscope is advanced through the nose or mouth to examine the trachea and bronchi
  4. Bronchoalveolar lavage (BAL) fluid is collected if needed
  5. Forceps biopsy, brush sampling, or transbronchial needle aspiration (TBNA) is performed from suspicious areas
  6. Rigid bronchoscopy is performed under general anesthesia for foreign body removal or airway interventions

Post-procedure

  • Rest under observation for 1-2 hours after the procedure
  • No food or drink until throat numbness resolves (approximately 2 hours)
  • No driving for 24 hours after the procedure
  • Mild sore throat and hoarseness usually resolve within 1-2 days
  • A follow-up appointment is scheduled for pathology and microbiology results

Risks

  • Mild sore throat, hoarseness, transient cough
  • Minor bleeding (especially after biopsy)
  • Pneumothorax (1-5% with transbronchial biopsy)
  • Transient drop in blood pressure and oxygen due to sedation
  • Rarely, severe bleeding or infection

FAQ

Is bronchoscopy painful?

Thanks to local anesthesia and sedation, the procedure is generally painless. Most patients remember it as a comfortable, sleep-like state.

What is the difference between flexible and rigid bronchoscopy?

Flexible bronchoscopy is performed for diagnostic purposes under sedation and can reach the smaller airways. Rigid bronchoscopy is performed under general anesthesia for foreign body removal, massive bleeding, or airway interventions.

When will the results be available?

Cytology and microbiology results typically take a few days, while a pathology report may take 5-10 business days.

Can I go home after the procedure?

Even if you are discharged the same day, you must be accompanied by another person and must not drive for 24 hours, as sedation is used.