Fiberoptic Bronchoscopy including bronchoalveolar lavage (BAL), EndoBronchial Biopsy (EBB)/TransBronchial Biopsy (TBLB)

Fiberoptic Bronchoscopy including bronchoalveolar lavage (BAL), EndoBronchial Biopsy (EBB)/TransBronchial Biopsy (TBLB)

Fiberoptic Bronchoscopy is a minimally invasive procedure which is used to look inside the airways and lungs using a thin, flexible tube called a bronchoscope. This tube has a light and camera that sends live images to a screen.

It helps the doctor to examine:

  • The Windpipe (trachea)
  • Bronchi (main lung airways)
  • Smaller airways
  • Areas of infection, bleeding, or tumor

Why is Fiberoptic Bronchoscopy Done?

It is done for both diagnosis and treatment in cases such as:

How is Fiberoptic Bronchoscopy performed?

  1. Pre-procedure Preparation: You will be asked to avoid eating or drinking for 4–6 hours before the procedure. Tests like chest X-ray, blood work, or ECG may be done before starting.
  2. Giving Sedation and Numbing: A local anesthetic is sprayed into the nose, throat, and airways to prevent the discomfort. You may also receive a mild sedative through a vein which helps you to relax.
  3. Inserting the Bronchoscope: The bronchoscope is passed through the nose or mouth, down the windpipe, and into the lungs. The doctor views the airways on a screen in real-time.
  4. Examining and Taking Samples: Depending on the findings, the doctor may:
  1. Completion and Observation: The procedure usually takes 15 to 30 minutes. Afterwards, you’ll observe your recovery for about 1–2 hours. You may feel mild throat irritation or cough for a day.
  2. Aftercare Instructions: Do not eat or drink anything for 1–2 hours after until your throat numbness wears off. Avoid hot food and drinks until the gag reflex returns. A mild cough or blood-tinged sputum is common for a short period of time. Results of biopsies or cultures may take a few days.

Special Techniques Performed During Bronchoscopy

1. Bronchoalveolar Lavage (BAL)

A small amount of sterile saline is passed into a part of the lung and then gently suctioned back. The fluid is collected and sent for microscopy, culture, and cytology to detect infections, inflammation, or cancer cells. It is very useful in pneumonia, tuberculosis, ILD, fungal infections, and occupational lung diseases.

2. Endobronchial Biopsy (EBB)

A tiny forceps is used through the bronchoscope to take a sample from visible growths or lesions inside the airways. Often performed when a tumor, swelling, or abnormal tissue is directly seen. It helps to diagnose lung cancer, tuberculosis, sarcoidosis, and airway tumors.

3. Transbronchial Lung Biopsy (TBLB)

Small tissue samples are taken from deeper lung areas which are not visible directly through the bronchoscope, using X-ray or fluoroscopy guidance. It is useful for diagnosing ILD, sarcoidosis, TB, certain lung infections, and rejection in lung transplant patients.

Frequently Asked Questions (FAQs)

No, the procedure is done under local anesthesia and sedation, so you’ll be relaxed and won’t feel any kind of pain.

The actual procedure takes around 15 – 30 minutes, but you may need to stay for a couple of hours for its preparation and recovery.

Yes, in most of the cases, it is a day – care procedure and once you are fully awake and able to perform your functions normally, you can go to your home.

Yes, it is a very safe test. Rare risks include minor bleeding, infection, or breathing difficulty, which are manageable.

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