Rigid Bronchoscopy for Children

A rigid bronchoscopy is a procedure used to examine the airway of the child starting from the throat or oropharynx, the voice box or the larynx, the windpipe or the trachea and lower airways or the bronchi.

What is a rigid bronchoscope?
A rigid bronchoscope is a metallic tube like equipment. A telescope is passed in the rigid bronchoscope which is used for visualizing the airway. The telescope provides an excellent view of the airways. This is displayed on a screen and can be recorded. Rigid bronchoscope is available in various sizes. Appropriate size of the rigid bronchoscope can be used depending on the age of the child.

How is rigid bronchoscopy done?
After the child is sedated and given general anaesthesia, the rigid bronchoscope is introduced through the mouth of the child and gradually advanced to the voice box or the larynx and then into the windpipe or the trachea of the child. Thereafter a proper examination of the airways is done on both the sides.

Rigid bronchoscopy is frequently combined with a flexible bronchoscopy to acquire and maintain better distal airway visualization and suctioning. If a foreign body is identified in the child’s airway, various instruments can be passed through the bronchoscopes like forceps, baskets, cryo etc for extraction of the foreign body. Various other procedures can be performed using a rigid bronchoscope.

When is a rigid bronchoscopy needed in children?
With the increasing experience in flexible bronchoscopy the need for rigid bronchoscopy has reduced. The most common indication of performing a rigid bronchoscopy in children is an old and badly stuck foreign body, a sharp foreign body or a foreign body in the voice box or larynx which cannot be removed with a flexible bronchoscope. Other indications of doing a rigid bronchoscopy are performing cryo-lung biopsy, closure of a trachea-esophageal fistula, airway recanalization using coring & balloon dilatation and placing a stent in the airway.

What are the advantages of a rigid bronchoscopy over a flexible bronchoscopy?
The main advantage of a rigid bronchoscope is that it allows a better control over the airway especially in sick children. In addition, a variety of the instruments are available for performing procedures like forceps, baskets, cryo etc. The instruments are larger and more sturdy compared to instruments used in flexible bronchoscopy.

Can rigid bronchoscopy be done under sedation or requires general anaesthesia?
Rigid bronchoscopy is performed in the operation theatre under general anaesthesia.

What preparation is required before rigid bronchoscopy in children?
The child needs to be fasting for six hours before the procedure and a pre-anaesthesia check up needs to be done.

How much time does it take to complete a rigid bronchoscopy?
The procedure time depends on the type of procedure. Usually it take around 20-30 minutes.

What can be complications of a rigid bronchoscopy in children?
Rigid bronchoscopy is a safe procedure with no/minimal complications.

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