Name of the Procedure:

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with destruction of tumor or relief of stenosis by any method other than excision (e.g., laser therapy, cryotherapy).

Summary

Bronchoscopy is a procedure where a doctor uses a thin, flexible or rigid tube (bronchoscope) to look inside the airways of the lungs. The procedure can include destroying tumors or relieving airway narrowing using methods like laser therapy or cryotherapy, and may involve fluoroscopic guidance for precision.

Purpose

Bronchoscopy is used to:

• Examine the airways and lungs.
• Remove benign or malignant tumors.
• Relieve obstructions or narrowing (stenosis) of the airways to improve breathing. The goal is to treat or manage lung conditions without needing invasive surgery.

Indications

• Persistent cough or unexplained lung issues.
• Detection and treatment of tumors in the airways.
• Stenosis causing breathing difficulties.
• Diagnostic evaluation for infections, inflammations, or abnormal growths in the lungs.

Preparation

• Fasting for about 6-12 hours before the procedure.
• Adjusting current medications, especially blood thinners, as instructed by the doctor.
• Pre-procedure diagnostic tests such as chest X-rays, CT scans, or lung function tests.

Procedure Description

1. The patient is positioned comfortably and given sedation or general anesthesia.
2. The bronchoscope, a flexible or rigid tube with a camera, is gently inserted through the nose or mouth.
3. Using fluoroscopic guidance, the doctor navigates to the affected area.
4. If a tumor or stenosis is found, methods like laser therapy or cryotherapy are used for destruction and relief.
5. The scope is carefully removed, and the patient is monitored for any immediate side effects.

Duration

The procedure typically lasts between 30 minutes to 2 hours, depending on the complexity.

Setting

Bronchoscopy is usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

• A pulmonologist or thoracic surgeon
• Nurses or respiratory therapists
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Common risks: Bleeding, infection, mild sore throat.
• Rare complications: Pneumothorax (collapsed lung), severe bleeding, adverse reactions to anesthesia.

Benefits

• Immediate relief from airway obstructions.
• Minimally invasive treatment of tumors.
• Faster recovery compared to traditional surgery.

Recovery

• Post-procedure monitoring for a few hours.
• Instructions may include avoiding strenuous activity for a day or two.
• Possible mild throat discomfort or hoarseness.
• Follow-up appointments for further assessment and care.

Alternatives

• Traditional surgical resection
• External beam radiation therapy
• Systemic chemotherapy These alternatives often involve longer recovery and more extensive procedures.

Patient Experience

Patients typically feel minimal discomfort during the procedure due to anesthesia. Afterward, some may experience a sore throat, mild cough, or hoarseness. Pain management includes lozenges, mild pain relief medications, and ample rest.