Bronchoscopy with Transbronchial Biopsy

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How is the Test Performed?

A lung specialist (pulmonologist) trained to perform a bronchoscopy sprays a topical or local anesthetic in your mouth and throat. This will cause coughing at first, which will cease as the anesthetic begins to work. When the area feels "thick," it is sufficiently numb.

You may be given an intravenous (IV) sedative to help you relax. This medication may make you sleepy and should reduce any anxiety you might have about the procedure. The procedure can also sometimes be performed using general anesthesia, during which you are unconscious and pain-free.

If the bronchoscopy is performed via the nose, an anesthetic jelly will be inserted into one nostril. When the nostril is numb, the scope will be inserted through the nostril until it passes through the throat into the trachea and bronchi. Usually, a flexible bronchoscope is used. This tool is a tube that is less than 1/2 inch wide and about 2 feet long.

As your doctor uses the bronchoscope is used to examine the airways of your lungs, he or she can also obtain samples of your lung secretions to send for laboratory analysis. Saline fluids may be used to flush the area and to collect cells that may need to be analyzed by a pathologist.

The transbronchial biopsy procedure is performed using a tiny forceps passed through a channel of the bronchoscope into your lungs. You will be instructed to breathe out slowly as the pulmonologist obtains a small sample of lung tissue. This step is usually repeated until several samples of tissue have been obtained for analysis. Occasionally real-time chest X-rays (fluoroscopy) are used during the bronchoscopy to help direct the forceps to the desired area of lung.