Flexible Bronchoscope / Rigid Bronchoscope

From (http://www.webmd.com/lung/bronchoscopy-16978)
There are two types of bronchoscopy.

• A flexible bronchoscope uses a long, thin, lighted tube to look at your airway. The flexible bronchoscope is used more often than the rigid bronchoscope because it usually does not require general anesthesia, is more comfortable for the person, and offers a better view of the smaller airways. It also allows the doctor to remove small samples of tissue (biopsy).
• A rigid bronchoscope is usually done with general anesthesia and uses a straight, hollow metal tube. It is used:
  • When there is bleeding in the airway that could block the flexible scope's view.
  • To remove large tissue samples for biopsy.
  • To clear the airway of objects (such as a piece of food) that cannot be removed using a flexible bronchoscope.

WHY IS IT DONE?

Bronchoscopy may be used to:

• Identify the cause of airway problems, such as bleeding, trouble breathing, or a long-term (chronic) cough.
• Take tissue samples when other tests, such as a chest X-ray or CT scan, show problems with the lung or with lymph nodes in the chest.
• Diagnose lung diseases by collecting tissue or mucus (sputum) samples for examination.
• Diagnose and determine the extent of lung cancer.
• Remove objects blocking the airway.
• Evaluate and treat growths in the airway .
• Control bleeding.
• Treat areas of the airway that have narrowed and are causing problems.
• Treat cancer of the airway using radioactive materials (brachytherapy).

HOW THE PROCEDURE WORKS:

Flexible bronchoscopy

During this procedure, you will lie on your back on a table with your shoulders and neck supported by a pillow, or you will recline in a chair that resembles a dentist's chair. Sometimes the procedure is done while you are sitting upright.
You will be given a sedative to help you relax. You may have an intravenous line (IV) placed in a vein. You will remain awake but sleepy during the procedure.
Before the procedure, your doctor usually sprays a local anesthetic into your nose and mouth. This numbs your throat and reduces your gag reflex during the procedure. If the bronchoscope is to be inserted through your nose, your doctor may also place an anesthetic ointment in your nose to numb your nasal passages.
Your doctor gently and slowly inserts the thin bronchoscope through your mouth (or nose) and advances it to the vocal cords. Then more anesthetic is sprayed through the bronchoscope to numb the vocal cords. You may be asked to take a deep breath so the scope can pass your vocal cords. It is important to avoid trying to talk while the bronchoscope is in your airway.
An X-ray machine (fluoroscope) may be placed above you to transmit an X-ray picture to a TV monitor. The picture on the monitor helps your doctor see any devices, such as forceps to collect a biopsy sample, that are being moved into your lung. The bronchoscope is then moved down your larger breathing tubes (bronchi) to examine the lower airways.
If your doctor collects sputum or tissue samples for biopsy, a tiny biopsy tool or brush will be used through the scope. A salt (saline) fluid may be used to wash your airway, then the samples are collected and sent to the lab to be studied.
Finally, small biopsy forceps may be used to remove a sample of lung tissue. This is called a transbronchial biopsy.

Rigid bronchoscopy

This procedure is usually performed under general anesthesia. You will lie on your back on a table with your shoulders and neck supported by a pillow.
You will be given a sedative to help you relax. You will have an intravenous line (IV) placed in a vein. A tube (endotracheal) will be placed in your windpipe (trachea) and a machine will help you breathe.
Once you are asleep, your head will be carefully positioned with your neck extended. Your doctor then slowly and gently inserts the bronchoscope through your mouth and into your windpipe.
If your doctor collects sputum or tissue samples for biopsy, a tiny biopsy tool or a brush will be inserted through the scope. A salt (saline) fluid may be used to wash your airway, then the samples are collected and sent to the lab for biopsy.