Flexible videobronchoscopy is a minimally invasive diagnostic and therapeutic tool used to visualize the airways and perform various procedures within the lungs. It's often performed using a flexible bronchoscope with a video camera, allowing real-time visualization of the tracheobronchial tree.
Here’s an overview of flexible videobronchoscopy and guided procedures like BAL (Bronchoalveolar Lavage), EBB (Endobronchial Biopsy), and TBLB (Transbronchial Lung Biopsy):
Evaluation of unexplained cough, hemoptysis, or abnormal chest imaging
Diagnosis and staging of lung cancer
Suspected infections (e.g., tuberculosis, fungal, PCP)
Foreign body retrieval
Performed under local anesthesia with sedation
The bronchoscope is inserted via the nose or mouth, into the trachea and bronchial tree
Continuous video feed aids navigation and visualization
Allows both diagnostic and therapeutic interventions
To collect cells, microorganisms, and other components from alveoli
Useful in diagnosing infections, interstitial lung diseases, malignancies
Sterile saline is instilled into a segment of the lung (usually 100–200 mL in aliquots)
Fluid is then aspirated and sent for microbiology, cytology, and biochemical analysis
Suspected infections in immunocompromised patients
Suspected diffuse parenchymal lung disease (e.g., sarcoidosis, hypersensitivity pneumonitis)
To obtain tissue from visible endobronchial lesions
Biopsy forceps are passed through the working channel of the bronchoscope
Targeted biopsy is taken under direct visualization
Suspected endobronchial tumors
Granulomatous diseases (e.g., sarcoidosis)
Inflammatory lesions
• To obtain lung parenchymal tissue from peripheral lung regions
Performed under fluoroscopic guidance to reduce risk of complications
Small biopsy forceps are advanced beyond the bronchoscope into peripheral lung tissue
Interstitial lung disease
Peripheral lung lesions or nodules
Opportunistic infections