Flexible Bronchoscopy

Monday - Friday 08:00-16:00Saturday and Sunday - CLOSED(02) 9487 8373info@sydneyrespiratoryspecialist.com.auParkway San ClinicWahroonga NSW 2076

Patient Information Sheets

This involves a small, flexible camera being inserted through your nose or mouth into your windpipes to have a look and visualise internal abnormalities.

What conditions is Flexible Bronchoscopy used for?
Am I asleep for the procedure? Where can I have it done?
What is the wait period to get a flexible bronchoscopy?
How long does it take? How long will I stay in Hospital?
What should I do in preparation for bronchoscopy?
What are the side effects of a flexible Bronchoscopy and lavage?
When can you return to work?
When will the results be available?

What conditions is Flexible Bronchoscopy used for?

Common symptoms and conditions that require a flexible bronchoscopy include persistent coughing, shortness of breath, pneumonia, fungal or parasitic lung infections, lung cancer, COPD, or lung inflammation caused by tuberculosis or sarcoidosis.
It may also be used if X-rays or other tests show something unusual.
A Flexible Bronchoscopy can detect infection, lung blockages, tumours, excess mucus and bleeding.
Samples can also be taken during the procedure.
Samples include brushing of airway walls, biopsy of abnormal areas and washout of the lungs using sterile saline to detect abnormal cells.
Difficult to diagnosed lung conditions like atypical infections and fungal infections can be diagnosed using flexible bronchoscopy.

Am I asleep for the procedure? Where can I have it done?

You will be having a general anaesthetic for all bronchoscopy procedures, with a dedicated anaesthetist looking after you. This ensures safety and optimal comfort for you.
For all patients, this procedure is performed under general anaesthetic; therefore, you will not be aware of the procedure.
The procedure can be booked at Macquarie University Hospital or Northern Beaches Hospital
If you do not have private health insurance, the procedure will be booked at Northern Beaches Hospital

What is the wait period to get a flexible bronchoscopy?

There is no wait period for bronchoscopy with Dr Herath.
Dr Herath is a an advanced bronchoscopist and thereby has her own lists in both public and private sector
The procedure will be done as urgently as possible as per the medical condition of the patient.
You do not need to be referred to another doctor to do your procedure which reduces the wait times and cost to you as the patient markedly.

How long does it take? How long will I stay in Hospital?

A Flexible Bronchoscopy with a lavage generally only takes 8-10 minutes for the procedure.
This is a day procedure and you can go home 1-2 hours after the procedure.
You will be monitored for two hours after your procedure.
You will be given a sip of water in 1 hour after the procedure, called a “sip test”.
This is to check that the local anaesthetic effect on your mouth has worn off and you can swallow without a risk of aspiration.
If you pass the test you will be given a light snack and discharged home.

What should I do in preparation for bronchoscopy?

Fast for 6 hours prior to the procedure for both food and fluid
If you are undergoing a biopsy stop blood-thinning tablet agents for 5 days pre procedure. Dr Herath will discuss this with you. (These include but not limited to Xeralto, Eliquis, Warfarin, Clopidogrel, Ticaglore)
You may continue aspirin even if you have a biopsy.
Dr Herath will contact your cardiologist or your referring respiratory physician to discuss if it is OK for you to stop blood thinners or if you require a “bridging agent” called Clexane or Heparin leading up to the procedure.
You should not take diabetic medication the morning of the procedure
You should take all other medications with a sip of clear water.
You need someone to drive you home and stay with you for one night. If this is not possible, we can organise for you to stay overnight in the hospital.
If you are a current smoker, stopping smoking for a period will immensely help in reducing airway discomfort and irritation. This will make the cough much better post procedure

What are the side effects of a flexible Bronchoscopy and lavage?

Flexible Bronchoscopy is a non-complicated safe procedure.
We do these procedures on daily basis and are prepared for types of adverse events during procedure and equipped to handle emergencies. Most side effects occur whilst you are in hospital and will be attended to with monitoring.
The rare side effects that may occur after discharge are listed so that you can watch out for them and act immediately.

Common side effects during or immediately after the procedure	What to Do
Cough post procedure Coughing blood mixed with sputum	Self-resolve over 24h
Tiredness	Self-resolve in 24h
Sore throat	Difflam lozenges or throat spray for 48h
Feeling as if you have flu (30% of patients after a wash/lavage)	Take paracetamol Take your temperature This should be below 38.5 C
Bleeding during procedure	We are prepared for a bleed specially during a biopsy.
Air leak outside the lung	If we anticipate an air leak, we will perform an USS or a Chest X ray to find out if this had occurred prior to discharge

Rare side effects Once you leave the hospital	What to Do
Infection and fever post procedure	Occurs 2-4 hours post procedure in 3% patients If you have fever >38.5 or feel unwell, you will need IV antibiotics and fluids. Please return to emergency department of the nearest hospital.
Shortness of breath/chest pain after going home	Shortness of breath is also a sign of pneumothorax or air leak outside the lung. If this occurs, please report to the nearest hospital emergency department.
Coughing up frank blood more than a tablespoon	However, coughing up frank blood more than a tablespoon is not normal. This is a sign of a larger bleed inside the lung. Please report to the nearest emergency department.

Although not mentioned above in the chart due to extreme rarity, adverse events due to anaesthesia, drug allergies, heart attacks, asthma exacerbations and even death can occur post procedures.
We will take extra precautions like booking an Intensive Care bed post procedure if you have underlying medical issues.
If you have multiple medical issues our bronchoscopist will discuss your individual risk and you will be referred to the pre-admission clinic for an anaesthetist to view your medical history and decide on the best level of anaesthesia for you.
The more medical issues you have the higher the chance of an adverse events the above chart is a general guide only.

When can you return to work?

You can return to work and start all your normal medications including blood thinners the next day.

When will the results be available?

Results will be available within one week.
Please book an appointment with our respiratory specialists one week after your procedure to discuss results and start treatment.
If you were referred by your Respiratory Physician or other specialist, please make an appointment with your specialist only.
The results will be copied to the referring specialist.

Start by uploading your referral to initiate the booking process.

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Our team will review your referral and confirm your appointment by phone. Understanding the urgency of your situation, we will prioritise scheduling at our earliest.

Upload all your medical reports (blood tests, CT scans, hospital discharge forms, clinical letters, lung function test reports, or relevant correspondence). This will allow the specialist to review them in advance for better preparation and more effective consultation.

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