Bronchoscopy is a procedure that looks inside the lung airways. It involves inserting a bronchoscope tube, with its light and small camera, through your nose or mouth, down your throat into your trachea, or windpipe, and to the bronchi and bronchioles of your lungs. This procedure is used to find the cause of a lung problem. It can detect tumors, signs of infection, excess mucus in the airways, bleeding, or blockages in the lungs. It also can allow your doctor to take samples of mucus or tissue for other laboratory tests, as well as to insert airway stents, or small tubes, to keep your airway open to treat some lung problems.

The procedure is performed using a flexible bronchoscope or a rigid bronchoscope. Flexible bronchoscopy is more common than rigid bronchoscopy, and flexible bronchoscopy usually does not require general anesthesia. Before the procedure, you will be given medicine to relax you. A liquid medicine also will be given to numb your nose and throat. If you have low blood oxygen levels during the procedure, you will be treated with oxygen therapy. If you have a lot of bleeding in your lungs or a large object is stuck in your airway, you may require rigid bronchoscopy in a hospital operating room under general anesthesia.

After the procedure, you will be monitored to make sure you don’t have complications. You may experience a sore throat, cough, or hoarseness that will go away with time. If you had the procedure as an outpatient, you likely will be able to go home after a few hours, but you will need a ride home because of the medicines or anesthesia you received. You will need to follow up with your doctor after the procedure to get your results.

Bronchoscopy is usually safe, but there is a small risk for fever, minor bleeding, or pneumonia. Pneumothorax, or collapsed lung, is a rare but serious side effect that can be treated. Your doctor may do a chest x ray after the procedure to check for lung problems.

The most common reason why your doctor may decide to do a bronchoscopy is if you have an abnormal chest x ray or chest computed tomography (CT) scan. These tests may show a tumor, a pneumothorax (collapsed lung), or signs of an infection.

A chest x ray takes a picture of your heart and lungs. A chest CT scan uses special x rays to take pictures of the inside of your body.

Other reasons for bronchoscopy include if you're coughing up blood or if you have a cough that has lasted more than a few weeks.

The procedure also can be done to remove something that's stuck in an airway (like a piece of food), to place medicine in a lung to treat a lung problem, or to insert a stent (small tube) in an airway to hold it open when a tumor or other condition causes a blockage.

Bronchoscopy also can be used to check for swelling in the upper airways and vocal cords of people who were burned around the throat area or who inhaled smoke from a fire.

In children, the procedure most often is used to remove something blocking an airway. In some cases, it's used to find out what's causing a cough that has lasted for at least a few weeks.

Bronchoscopy usually is a safe procedure. However, there's a small risk for problems, such as:

• A drop in your oxygen level during the procedure. Your doctor will give you oxygen if this happens.
• Minor bleeding and developing a fever or pneumonia.

A rare, but more serious side effect is a pneumothorax. A pneumothorax is a condition in which air or gas collects in the space around the lungs. This can cause one or both lungs to collapse.

Usually, this condition is easily treated or may go away on its own. If it interferes with breathing, a tube may need to be placed in the space around the lungs to remove the air.

A chest x ray may be done after bronchoscopy to check for problems.

Your doctor will do the bronchoscopy in an exam room at a special clinic or in a hospital. The bronchoscopy itself usually lasts about 30 minutes. But the entire procedure, including preparation and recovery time, takes about 4 hours.

Your doctor will give you medicine through an intravenous (IV) line in your bloodstream or by mouth to make you sleepy and relaxed.

Your doctor also will squirt or spray a liquid medicine into your nose and throat to make them numb. This helps prevent coughing and gagging when the bronchoscope (long, thin tube) is inserted.

Then, your doctor will insert the bronchoscope through your nose or mouth and into your airways. As the tube enters your mouth, you may gag a little. Once it enters your throat, that feeling will go away.

Your doctor will look at your vocal cords and airways through the bronchoscope (which has a light and a small camera).

The animation below shows a bronchoscopy procedure. Click the "start" button to play the animation. Written and spoken explanations are provided with each frame. Use the buttons in the lower right corner to pause, restart, or replay the animation, or use the scroll bar below the buttons to move through the frames.

The animation shows how a doctor inserts a bronchoscope into a patient’s nose and passes it down into the airways. This allows the doctor to look inside the airways.

During the procedure, your doctor may take a sample of lung fluid or tissue for further testing. Samples can be taken using:

• Bronchoalveolar lavage (BRON-ko-al-VE-o-lar la-VAHZH). For this method, your doctor passes a small amount of salt water (a saline solution) through the bronchoscope and into part of your lung. He or she then suctions the salt water back out. The fluid picks up cells and bacteria from the airway, which your doctor can study.
• Transbronchial lung biopsy. For this method, your doctor inserts forceps into the bronchoscope and takes a small sample of tissue from inside the lung.
• Transbronchial needle aspiration. For this method, your doctor inserts a needle into the bronchoscope and removes cells from the lymph nodes in your lungs. These nodes are small, bean-shaped masses. They trap bacteria and cancer cells and help fight infection.

You may feel short of breath during bronchoscopy, but enough air is getting to your lungs. Your doctor will check your oxygen level. If the level drops, you'll be given oxygen.

If you have a lot of bleeding in your lungs or a large object stuck in your throat, your doctor may use a bronchoscope with a rigid tube. The rigid tube, which is passed through the mouth, is wider. This allows your doctor to see inside it more easily, treat bleeding, and remove stuck objects.

A rigid bronchoscopy usually is done in a hospital operating room using general anesthesia. The term "anesthesia" refers to a loss of feeling and awareness. General anesthesia temporarily puts you to sleep.

After the procedure is done, your doctor will remove the bronchoscope.

After bronchoscopy, you'll need to stay at the clinic or hospital for up to a few hours. If your doctor uses a bronchoscope with a rigid tube, the recovery time is longer. While you're at the clinic or hospital:

• You may have a chest x ray if your doctor took a sample of lung tissue. This test will check for a pneumothorax and bleeding. A pneumothorax is a condition in which air or gas collects in the space around the lungs. This can cause one or both lungs to collapse. Usually, this condition is easily treated.
• A nurse will check your breathing and blood pressure.
• You can't eat or drink until the numbness in your throat wears off. This takes 1 to 2 hours.

After recovery, you'll need to have someone take you home. You'll be too sleepy to drive.

If samples of tissue or fluid were taken during the procedure, they'll be tested in a lab. Talk to your doctor about when you'll get the lab results.

Recovery and Recuperation

Your doctor will let you know when you can return to your normal activities, such as driving, working, and physical activity. For the first few days, you may have a sore throat, cough, and hoarseness. Call your doctor right away if you:

• Develop a fever
• Have chest pain
• Have trouble breathing
• Cough up more than a few tablespoons of blood