31646 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, subsequent, same hospital stay

Name of the Procedure:

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, subsequent, same hospital stay

Summary

A bronchoscopy is a medical procedure that allows doctors to look at the airways in your lungs using a thin tube called a bronchoscope. This procedure can be done with either a flexible or rigid bronchoscope and often involves fluoroscopic guidance for better visualization. During the procedure, therapeutic aspiration is performed to remove any obstructions or fluids from the airways.

Purpose

The purpose of a bronchoscopy with therapeutic aspiration is to diagnose and treat issues within the tracheobronchial tree, such as blockages due to mucus, foreign objects, or abnormal growths. The expected outcome is to clear the airways, improve breathing, and provide diagnostic information if needed.

Indications

• Persistent cough
• Unexplained wheezing or shortness of breath
• Suspected lung infection or tumor
• Removal of foreign objects
• Clearance of mucus plugs in conditions like COPD or cystic fibrosis
• Monitoring and treatment of airway complications in patients with respiratory diseases

Preparation

• Fasting for at least 6-8 hours before the procedure
• Adjusting current medications as advised by the doctor (especially blood thinners)
• Pre-procedure tests such as blood work, chest X-ray, and possibly a CT scan
• Signing a consent form after discussing the risks and benefits with the healthcare provider

Procedure Description

1. The patient is sedated or under general anesthesia to ensure comfort.
2. The bronchoscope (either rigid or flexible) is gently inserted through the mouth or nose and moved down the throat into the lungs.
3. Fluoroscopic guidance is used to navigate and visualize the tracheobronchial tree.
4. Therapeutic aspiration tools are used to suction out any blockages, mucus, or foreign objects.
5. The bronchoscope is carefully removed after the airway is cleared.
6. The patient is monitored until the sedation or anesthesia wears off.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

A hospital or a surgical center, often in a specialized procedure room.

Personnel

• Pulmonologist or thoracic surgeon
• Anesthesiologist or nurse anesthetist
• Registered nurses and respiratory therapists

Risks and Complications

• Throat irritation or soreness
• Bleeding
• Infection
• Bronchospasm (sudden constriction of the airways)
• Rarely, injury to the airways

Benefits

• Improved breathing and relief from symptoms caused by airway blockages
• Accurate diagnosis and treatment of lung conditions
• Immediate improvement in respiratory function in many cases

Recovery

• Patients are monitored in a recovery area until the effects of anesthesia wear off.
• Mild throat discomfort may be experienced and can be managed with lozenges or pain relievers.
• Patients can usually go home the same day but should avoid strenuous activities for 24-48 hours.
• Follow-up appointments may be necessary to monitor recovery or results of the procedure.

Alternatives

• Chest physiotherapy or postural drainage for mucus clearance
• Medications, such as bronchodilators or mucolytics
• Less invasive imaging techniques like CT scans for diagnostic purposes
• Each alternative may vary in effectiveness and invasiveness compared to bronchoscopy.

Patient Experience

• During the procedure, patients typically feel no discomfort due to sedation or anesthesia.
• Post-procedure, they may experience mild throat soreness and fatigue.
• Pain is usually minimal and managed with over-the-counter medications if needed.