Rigid bronchoscopy

Learning objectives

To gain better access to the patient’s airway
Allows insertion of instruments or airway devices
Diagnosis of infections, cancers, inflammatory conditions, sarcoidosis, and lymphoma
Treatment of airway obstruction, airway narrowing (stenosis), airway cancers, bleeding
Removal of foreign or aspirated objects
Considerations for surgical technique: stenting, laser, endobronchial electrosurgery, argon plasma coagulation, & balloon bronchoplasty

Advantages	Disadvantages
Can be inserted past airway obstruction	Requires always general anesthesia
The airway is secure during the procedure	Oral and pharyngeal damage
Allows for: Larger biopsies Tamponade (stop) bleeding areas Removal of airway tumors and foreign objects Deploying airway devices (tracheobronchial stents) to keep collapsing airways open	Limited visualization
	Nonflexible metal rod

Patients requiring high levels of supplemental O2
Patients with baseline hypercarbia and hemodynamic instability
Unstable cervical spine or diminished range of motion of the cervical spine caused by spondylosis
Maxillofacial trauma or oral disease preventing opening of the jaw (stenosis, obstructing neoplasms)
Procedure-specific complications: hemorrhage, airway trauma, perforation, fire, systemic gas embolism, & dissemination of post-obstructive pneumonia

Full stomach vs. unsecured airway
High oxygen requirements with risk of fire ignition
Jet ventilation through obstructing stenoses with risk of air trapping & barotrauma