Name of the Procedure:

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; each additional major bronchus stented

Summary

Bronchoscopy is a medical procedure that allows doctors to view the airways and lungs using a thin tube called a bronchoscope. This procedure may involve inserting stents into the bronchi (major airways) to keep them open, using X-ray imaging for guidance.

Purpose

The procedure is designed to diagnose or treat conditions affecting the airways and lungs. It helps in maintaining open airways in patients with blockages, tumors, or strictures, thereby improving breathing and preventing complications.

Indications

Bronchoscopy is indicated for patients with:

• Airway obstructions due to tumors or growths
• Severe asthma or chronic obstructive pulmonary disease (COPD)
• Persistent cough or unexplained symptoms
• Need for airway stenting due to collapse or narrowing
• Abnormal findings on imaging tests
• Need for biopsies of lung tissue

Preparation

• Patients may need to fast for several hours before the procedure.
• Blood tests and imaging may be required for preparation.
• Changes to medication schedules, particularly blood thinners, may be advised.

Procedure Description

1. The patient is given local anesthesia or sedation.
2. A bronchoscope (rigid or flexible) is inserted through the mouth or nose into the airways.
3. Fluoroscopic guidance (live X-ray) is used to navigate the major bronchus and place stents as needed.
4. Additional treatments or biopsies may be performed during the bronchoscopy.

Duration

The procedure typically takes between 30 minutes to an hour, depending on complexity and the number of stents placed.

Setting

The procedure is usually performed in a hospital's endoscopy suite or an outpatient surgical center.

Personnel

• Pulmonologist or thoracic surgeon
• Nurses and respiratory therapists
• Anesthesiologist or nurse anesthetist

Risks and Complications

• Bleeding
• Infection
• Perforation of airways
• Adverse reaction to sedatives or anesthesia
• Respiratory issues post-procedure

Benefits

• Improved airway patency and breathing
• Relief from symptoms related to airway obstruction
• Immediate diagnostic information from direct airway visualization

Recovery

• Observation in a recovery area until sedation wears off
• Temporary sore throat or mild cough
• Instructions on activity limitations, typically for 24 hours
• Potential follow-up for stent assessment or additional treatment

Alternatives

• Conservative management with medication
• Non-invasive imaging for diagnosis
• Surgical interventions if appropriate

Patient Experience

• Mild discomfort or cough during the procedure
• Relief of symptoms often felt quickly after stenting
• Pain management provided during recovery, including throat lozenges and pain medications

--- This markdown description aims to provide a comprehensive and understandable guide about the bronchoscopy procedure, focusing on the placement of additional major bronchus stents.