A bronchoscope is a special optical medical device used to study the respiratory tract (lungs and bronchi). It looks like a tube with an optical and lighting system. The design of the bronchoscope allows you to enter drugs, remove mucus and blood, foreign bodies. In order to do a biopsy, special handling tools are placed in the device. The camera work is coordinated and digitized, so the course of the procedure is immediately displayed on the monitor.
Types of bronchoscopes
There are two types of bronchoscopes: rigid and flexible. Let us understand the features of the application of each type.
Flexible bronchoscopy is also called fibrobronchoscope. Flexible bronchoscope consists of a tube with an optical part and a light guide. At the input end, there is a camera, and on the outside, there is a special handle for controlling the device. The visual and viewing tube is flexible and smooth. The diameter is about 3.6-6.6 mm. If the pediatric bronchoscope, the cross-section of the tube is even smaller - 1.8 mm. The length in adult and child models up to 60 cm.
Features of the use of a fibrobronchoscope:
- examinations and manipulations are carried out under local anesthesia, the patient is conscious;
- has less trauma compared to a hard bronchoscope;
- it can even penetrate the lower parts of the bronchial tree;
- widely used in pediatric practice and has the least number of complications.
Some difficulties in carrying out the procedure may arise from the fact that the patient is conscious and is afraid of future examination. Despite the fact that the practices are less traumatic, complications do occur. With the rough application of the equipment, nosebleeds may occur. Biopsy also causes minor bleeding episodes that are easy to handle.
When performing a more complex procedure such as transbronchial lung biopsy, the consequences may not be limited to weak bleeding. In severe cases, pneumothorax occurs. It can either resolve itself or require additional intervention.
Patients may have various side effects when applying local anesthesia. In this case, the procedure is performed under total anesthesia.
In another way, it is called rigid. A rigid bronchoscope is a solid tube with an optical and video system at one end and a manipulator at the other. The diameter is about 5-15 mm.
Features of the application of a rigid bronchoscope:
- the procedure becomes extremely traumatic;
- examination and manipulation are carried out only under general anesthesia;
- suitable for removing large foreign items from the bronchus;
- used in case of extensive bleeding;
- for more precise application in the small bronchi, a fibrobronchoscope can be inserted;
- it is useful when conducting resuscitation in case of liquid accumulation in the lungs;
- when pathology is detected, it allows you to immediately perform a biopsy or complete removal of the altered tissue.
Complications of rigid bronchoscopy:
- perforation of the bronchi;
- aspiration of stomach contents;
- bleeding due to coarse procedure or extensive biopsy.
Usually, many complications exist due to the use of general anesthesia with insufficient premedication or an incorrect dose of anesthetic applied.
Most popular models
In the world, there are several companies that produce endoscopic equipment used everywhere. They are characterized by a large selection of products, best quality, and extensive experience in the development of medical equipment.
Leading endoscopes manufactures are:
- Olympus (Japan);
- Everest VIT (USA);
- Pentax (Japan);
- Karl Storz (Germany);
- Saraya Co. (Japan);
Moreover, Optimed also deserves special attention. The company, founded in St. Petersburg and has extensive experience in the production of endoscopic equipment.
The choice of a bronchoscope depends on the individual characteristics of the patient and the purpose of the bronchoscopy. The preference is usually given to the fibrobronchoscope and only in severe cases, when a flexible bronchoscope is not enough, a rigid one is used.