Rigid bronchoscopy: a general overview
Rigid bronchoscopy developed from an esophagoscope first used by Gustav Killian for the removal of a foreign body. Today rigid bronchoscopes come in a few varieties which differ mainly in their assembly, but the main components are the same. The rigid bronchoscope is used in both therapeutic and diagnostic cases including: tumor excision, stent placement, airway stenosis, and control of hemoptysis. It is imperative to undergo presurgical evaluation by the proceduralist as well as anesthesiologist prior to the procedure which allows discussion of risks and benefits and correction of any reversible contraindication. During the case the type of anesthesia will vary depending on the institution and their comfort level, but the combination of a hypnotic, narcotic and paralytic are the most common combination. After general anesthesia is administered the patient is intubated with the rigid bronchoscope and attached to the ventilator. The most common modes of ventilation are: spontaneous assisted ventilation, positive pressure ventilator and jet ventilation. Reported complications include: damage to the oropharynx, teeth and vocal cords; hemorrhage, hypoxia and laryngospasm. In experienced hands, rigid bronchoscopy is a safe procedure and can offer improved quality of life in those with central airway obstruction.