Name of the Procedure:

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body

Summary

A bronchoscopy is a procedure that allows doctors to look inside the airways of the lungs using a thin, tube-like instrument called a bronchoscope. This procedure can be performed using either a flexible or rigid bronchoscope. It is sometimes combined with fluoroscopic guidance (real-time X-ray imaging) to help guide the bronchoscope. This particular procedure involves removing a foreign body that has been inhaled into the airways.

Purpose

The procedure is conducted to remove foreign objects that have been accidentally inhaled into the airway, which can obstruct breathing and pose serious health risks. The goal is to clear the blocked airway, restore normal breathing, and prevent complications such as infections or lung damage.

Indications

• Suspected or confirmed aspiration of a foreign body
• Symptoms such as chronic cough, wheezing, difficulty breathing, or recurrent pneumonia
• Abnormal imaging findings indicating a foreign object in the airways

Preparation

• Patients may be asked to fast for several hours before the procedure.
• Pre-procedure assessments like chest X-rays or CT scans might be required.
• Medication adjustments may be necessary, especially for blood thinners.
• The healthcare provider will review the patient's medical history and allergies.

Procedure Description

1. The patient is typically given sedation or general anesthesia to ensure comfort.
2. A bronchoscope is inserted through the patient's nose or mouth and slowly advanced into the airways.
3. Fluoroscopic guidance may be used to help navigate and locate the foreign body accurately.
4. Once the foreign body is located, specialized tools are passed through the bronchoscope to grasp and remove the object.
5. The airways are then examined to ensure no additional obstructions or injuries are present.

Duration

The procedure typically takes 30 minutes to an hour, depending on the complexity and location of the foreign body.

Setting

Bronchoscopies are usually performed in a hospital setting, specifically in an operating room or an endoscopy suite.

Personnel

• A pulmonologist or thoracic surgeon who specializes in airway management
• Anesthesiologist for sedation and monitoring
• Nursing staff to assist with the procedure and patient care

Risks and Complications

• Bleeding from the airway
• Infection
• Airway perforation or injury
• Reaction to sedation or anesthesia
• Temporary sore throat or hoarseness

Benefits

• Immediate relief from airway obstruction
• Prevention of potential complications such as lung infections or damage
• Enhanced breathing and overall airway function

Recovery

• Patients are typically monitored for a few hours after the procedure.
• Post-procedure instructions may include rest, avoiding strenuous activities, and symptom monitoring.
• Follow-up appointments may be necessary to ensure proper healing and function.

Alternatives

• Observation and conservative management, although less effective for immediate obstruction relief
• Surgical removal, which is more invasive and usually reserved for cases where bronchoscopy is not possible

Patient Experience

• The patient may experience mild discomfort or a sore throat after the procedure.
• Pain management is typically available to handle any minor post-procedural discomfort.
• Most patients can return to normal activities within a day, although some may experience fatigue or mild respiratory symptoms temporarily.