Rigid Broncoscopy

Abstract

Rigid bronchoscopy was the first available method to inspect and treat airway conditions. Its application increased until the flexible bronchoscope (FB) was made available. The flexible bronchoscope became very popular and virtually replaced the rigid bronchoscope (RB) application, until Dr. Dumon modified the old RB and made it suitable for laser application. From then on, the RB regained popularity and continues interesting pulmonary physicians that treat severe pulmonary conditions such as lung cancer, airway stenosis, airway bleeding.

The rigid bronchoscope has unique features that make it irreplaceable: it allows complete control of the airway while performing procedures; it can confront acute and severe conditions such as critical airway obstruction and life-threatening hemoptysis safely and effectively. The RB can be used as an airway dilator itself; it can compress a bleeding area and it can also resect airway endobronchial tumors to open a compromised airway. It is a very useful tool in foreign body removal, particularly in the pediatric population. Application of different airway opening methods can be accomplished through the RB: laser resection, electrocautery, argon plasma coagulation, cryotherapy. Endobronchial silicone stents can be easily placed and removed with the rigid bronchoscope. Its use has been associated with good therapeutic results, and in well-trained hands the expected complication rate is very low.

The RB continues to be a very useful tool in interventional pulmonology and has not been replaced by any other available instrument. Rigid bronchoscopy training should be a requirement to any pulmonary bronchoscopist willing to deal with therapeutic interventions.