This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science
This page was updated on June 13, 2022.
The doctor uses a bronchoscopy to look inside the air passages of the patient's lungs. During this procedure, the provider inserts a thin tube called a bronchoscope through the mouth or nose, down the throat and into the lungs.
There are several types of bronchoscopy that the care team may perform.
Flexible bronchoscopy: This is the most common type of bronchoscopy. During this procedure, a thin and flexible scope is inserted through the nose or mouth. The bronchoscope is passed down the back of the throat and between the vocal cords to enter the air passages. A camera in the scope sends pictures to a video screen during the procedure.
Rigid bronchoscopy: This procedure also looks inside the air passages of the lungs, but the tube is larger and not flexible. A rigid scope can only be placed through the mouth. It’s less common than flexible bronchoscopy.
Navigational bronchoscopy: During this procedure, a steerable catheter is inserted through a bronchoscope. The catheter is then directed to masses in the airway.
Robotic bronchoscopy: This procedure may be performed when the area of concern can't be reached using a traditional navigational bronchoscopy. During this procedure, a robotic arm directs a catheter through the patient's airways.
Autofluorescence bronchoscopy: This procedure allows the care team to identify potentially cancerous cells in the bronchial tubes that may not be available using white light examination. It uses a blue light to detect potentially abnormal cells.
There are many reasons for flexible bronchoscopy. The most common ones include:
Infections: If the patient has frequent lung infections, samples of lung tissue or secretions can be removed through the scope and studied in the lab.
Biopsy: If an imaging study shows a spot on the patient's lung, a piece of lung growth may be taken to diagnose a cancerous tumor or another condition. When the care team removes a piece of tissue during the bronchoscopy to study under a microscope, it's called a bronchoscopy biopsy.
Atelectasis: If an area of the patient's lung has become blocked and has collapsed, called atelectasis, thick mucus, or a foreign body (like a piece of peanut), may be removed. If it’s a tumor, it may be biopsied.
Coughing up blood: If the patient is coughing up blood, bronchoscopy may determine the cause. It can be an abnormal blood vessel or a tumor. In some cases, bleeding can be treated through the scope.
Breathing issues: If the patient has trouble breathing or noisy breathing, bronchoscopy may be performed to find the cause of the obstructed breathing.
Bronchoscopy may also be done if the patient has been diagnosed with lung cancer to find the stage of the cancer—how far cancer has grown—and to decide if the cancer can be removed by surgery or needs a different type of treatment.
Although rigid bronchoscopy is an older procedure that has mainly been replaced by flexible bronchoscopy, rigid bronchoscopy is still important for certain conditions. These include removing a central airway obstruction that is too large for the flexible scope, removing a large foreign body and treating severe bleeding.
To prepare for a bronchoscopy, which is usually an outpatient procedure, patients should take these steps:
Though bronchoscopy is usually performed on an outpatient basis, the patient will need anesthesia or sedation for the procedure. Patients should have someone available to drive them home afterward.
Bronchoscopy is a safe procedure, but risks and complications can occur. One possible risk is that the patient's oxygen level will fall during the procedure because of the scope blocking his or her breathing. The surgical team will constantly check the patient's oxygen levels and add oxygen if needed. Other possible risks include:
Pneumothorax is a rare complication that may occur when a biopsy is taken. A leak of air from the lung can escape into surrounding tissue and cause part of the lung to collapse. A small leak may close without treatment, but a collapsed lung must be treated with a chest tube to re-expand the lung, according to the Chest Foundation.
Flexible bronchoscopy is usually performed with intravenous (IV) sedation. Rigid bronchoscopy is performed under general anesthesia, which means the patient will be asleep.
The patient will receive oxygen throughout the procedure whether he or she is awake or asleep. The procedure usually takes about 30 to 60 minutes. It may take longer if the patient has an imaging study during the procedure, such as an endobronchial ultrasound, which creates images with sound waves from inside the lung.
Steps routinely used for flexible bronchoscopy include:
During the procedure, the doctor will examine the patient's airways and perform tests or procedures as needed.
After the procedure, the patient will be brought to an area to recover from the sedation or general anesthesia. Until the patient is awake and any numbness in his or her throat has worn off, he or she will not be allowed to eat or drink. Recovery may take anywhere from one to three hours.
The patient may also be given a chest X-ray to make sure there is no evidence of pneumothorax before returning home. It may take a few days to get results of tests or biopsies done during the procedure. However, the care team may describe what was found during the procedure before the patient goes home.
Once home, it's normal to have some throat soreness. It's not uncommon to have a low-grade fever for a day or two, but let the care team know about any of these symptoms:
Let the doctor know right away or get immediate attention if chest pain or trouble breathing occur. These could be signs of pneumothorax. Bronchoscopy results may be available right after the procedure, but they usually take one to three days. At that point, the care team will share the results and may indicate whether any further testing is necessary.