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Learn more about bronchoscopy

Introduction

 

In 1897, Gustav Killian, the "father of bronchoscopy," first viewed the trachea and main bronchi through the larynx via a rigid, hollow tube. He quickly realized that the utility of his new invention was not limited to visualizing the airways. Later that same year, he removed a bone lodged in the right main bronchus of one of his patients. Bronchoscopy and interventional pulmonology were born. Modifications and improvements to the bronchoscope were made over the years. In 1904, Chevalier Jackson equipped the bronchoscope with an electric light source at the distal end and also added a suction channel. Early in the 1960s Shigeto Ikeda devised a means to replace the small electric bulb with glass fibers capable of transmitting brighter light from an outside source. The device worked so well that he requested Machida and Olympus to create a prototype for a flexible fiberscope using fiberoptics. He presented the first flexible bronchoscope at the 1966 International Congress on Diseases of the Chest in Copenhagen. Following his success, he continued to strive to make further improvements to the scope. At the end of the 1980s, Asahi Pentax replaced the fiberoptic bundle with a charge-coupled sensor at the tip of the scope. This videobronchoscope allowed the bronchoscopist to look at a monitor screen instead of through the eyepiece of the scope.

Bronchoscopy is now an integral part of respiratory medicine. Diagnostic indications include tissue diagnosis, detection and staging of lung malignancy, evaluation of diffuse lung diseases like sarcoidosis and idiopathic interstitial pneumonias, pulmonary inspection of burn patients, identification of organisms infecting the respiratory tract and lungs. As a therapeutic modality, bronchoscopy is used to place stents to protect airways vulnerable to collapse or occlusion, to remove foreign bodies or masses and to treat early stage endobronchial malignancy.

Currently we are experiencing a new wave of fascinating techniques in diagnostic and therapeutic technology. Endobronchial ultrasound, electromagnetic navigation, optical coherence tomography and alveoloscopy are the most recent additions to diagnostic bronchoscopy. Recent therapeutic advances include intrabronchial valve placement for nonsurgical lung resection and thermoplasty for difficult-to-treat asthma.
 
Resources:
 
Bronchoscopy International: 
 
 
BTS Bronchoscopy Guidelines: www.brit-thoracic.org.uk
 
 
Bronchoscopy Simulator