Bronchoscopy and Thoracoscopy

Bronchoscopy and Thoracoscopy are procedures that are both performed in the Endoscopy Department at The County Hospital. They are both a form of investigation to examine the lungs but the way they are carried out is very different. They are both carried out by a respiratory consultant, sometimes two. In the case of thoracoscopy, there is also the addition of an anaesthetist.

Bronchoscopy and Endobronchial Ultrasound (EBUS)

A bronchoscopy is a test where a Respiratory Consultant looks into the lungs using a flexible tube with a camera and light at one end. This procedure is performed under conscious sedation which means that medication is given via a cannula in the hand or arm that makes the patient sleepy, but not fully asleep. Patients who undergo this procedure tend to tolerate it well and have little memory of the procedure itself.

The procedure allows the doctor to visualise the large breathing tubes of the lungs to look for any changes at the surface. Samples can also be taken in the form of brushings, washings or trappings (where a small piece of the lung lining is taken for testing). This is important in the diagnosis of certain lung diseases that would otherwise not be picked up through less invasive means.

EBUS is a form of bronchoscopy where there is also the addition of a fluid-filled balloon and ultrasound scanner alongside the camera and light. This test requires two members of the respiratory team to operate the bronchoscope. This allows for visualisation of the structure of the lung below the surface lining and can enable the respiratory physician to be able to take targeted tissue samples directly from lymph nodes found within the lung using a needle.

It can take around seven to ten days for a bronchoscopy result to come back and in some cases it can be longer than that.

Thoracoscopy

Thoracoscopy is the visualisation of the outer lining of the lung from within the chest cavity. Usually this is carried out on patients who have a pleural effusion (fluid build-up in the chest) that requires further investigation for which its cause has not been found by other means.

This test also involves an anaesthetist who helps with sedating the patient. A keyhole is made in the chest to allow for a rigid camera and light with space for other utensils to pass through. The lung is intentionally collapsed and the fluid is drained whilst samples are taken directly from the lining of the chest wall whilst the lining of the lung is visualised for any signs of disease. After this procedure a chest drain is fitted and patients are admitted to Arrow ward, the Respiratory Ward at The County Hospital. After 24 hours of observation people are usually discharged home to await their results for which they will be invited to attend clinic.