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A medical procedure placing a tube into the lung airways through the nose or mouth.
More than 500,000 bronchoscopies and an estimated 190 thousand transbronchial biopsies are performed annually in the US.
Scopes may be rigid or flexible.
A rigid bronchoscope is a straight, metal tube and is the tube of choice for removing foreign materials in the airway.
The rigid scope is thick and allows instruments t be more easily inserted through it.
Rigid scopes are useful in the presence of bleeding that interferes with the viewer vision and allows for greater degree of intervention, such as cauterization.
Fiber optic flexible bronchoscopes transmit light images as the tube bends.
flexible scopes allow investigation to reach further in the airways.
Performed safely under local anesthesia.
Flexible scopes have mostly replaced rigid scopes for most procedures.
Advances in technology include robotic assisted bronchoscopy, and intraprocedural three dimensional imaging have improved the ability to navigate the lung periphery with high precision.
Diagnostic yieldsof trans bronchial biopsy is 55 to 70%, depending on the indication for bronchoscopy.
Bronchoscopic biopsies conventionally performed with forceps, which can result in small specimens and poor specimen quality due to crush artifact.
The diagnostic yield of transbronchial lung biopsy is significantly higher with the use of 1.1 mm cryoprobe versus 2 mm forceps in patients with pulmonary nodules or masses, lung transplant, and diffuse parenchymal lung disease.