1. The history of bronchoscopy began in 1885 with direct visualization of the larynx. Key developments included the first bronchoscopy in 1907 and introduction of the flexible bronchoscope in 1967. 2. There are two main types of bronchoscopes: rigid bronchoscopes and flexible bronchoscope (FOB). Rigid bronchoscopes allow for ventilation but require general anesthesia, while FOBs can be done at the bedside without anesthesia but have lower navigational power. 3. Bronchoscopy has diagnostic indications such as investigating cough, wheeze, stridor, diagnosing lung cancer, and obtaining samples. Therapeutic indications include removing foreign bodies, treating airway tumors, and dilating airway str

1. MOHAMED
GABR
BRONCHOSCOPY
Cardiothoracic surgery specialist at Muh
Mansoura university 2019

2. History of Bronchoscopy
1885: Kirstein visualized the interior of a patient’s larynx directly with
O’Dwyer’s tube.
1897: Gustav Killian known as the ‘father of bronchoscopy’
1905: Chevalier Jackson established bronchoscopy as a standard diagnostic
tool.
1907: Inokichi Kubo was the first to practice bronchoscopy.
1967: Shigeto Ikeda introduced the first flexible FOB.

3. Types of Broncho.
1- RIGID

5. 2- FOB

6. FOBRigid Bronchoscope
Advantages
- Flexible
- Can be done at bedside
- High navigational power
- (complete airway survey)
- No need for general anesthesia
- can be used through ETT
- can be used in truama
- Cheap
- Available
- Wide lumen of working channel
- Larger size accessories
- allows larger biopsies
- Ventilating
- FOB can be done through it
Disadvantages
- Expensive
- Cann`t protect airway
- Non ventilating
- Not easily available
- Low navigational power
- Requires general anesthesia (OR)
- cann`t be used in trauma

7. Indications
1- Diagnostic indications:
- investigation of unexplained cough, localized wheeze
or stridor
- diagnosis bronchogenic carcinoma
- evaluation of tracheal stenosis
- biopsy in mediastinal, lung masses (EBUS & TBNA)
- staging of bronchogenic carcinoma
- to exclude endobronchial lesions
- evaluation lung lesion of unknown etiology on CXR
- investigation unexplained hemoptysis
- evaluation airway trauma
- obtain BAL for microbiological analysis
- evaluation suspected TOF
- evaluation suspected BPF
- evaluation unexplained pleural effusions

8. 2- Therapeutic indications:
- removal of FBs
- control of hemoptysis
- removal of retained secretions
- treatment of trachea-bronchial stenosis
- treatment of airway tumors
- difficult intubation (FOB intubation)
- closure of BPF
- treatment of emphysema
- therapeutic BAL

9. Complications:
- Hypoxia
- Pneumothorax
- Airway injury
- Bleeding
- Respiratory failure

15. Anatomy

20. Malignant & Benign Endobronchial Lesions

21. Airway Stricture LASER dilatation Recurrence Silic. Stenting

22. Electrocautary of Granulation t. distal to bronchial stent

23. Tracheal Stenosis: 0 – 50% 51-70%
71 – 99% 100% ???

24. Post-intubation Tracheal Stenosis
Stenosis Normal

25. Tracheal Stenting in Tracheomalacia

27. Questions:
1- Compare between rigid and flexible bronchoscopes
2- Indications of rigid bronchoscope
3- Diagnostic indications of bronchoscope
4- Therapeutic indications of bronchoscope

28. Thank you
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