This information will help you prepare for your rigid bronchoscopy at Memorial Sloan Kettering Cancer Center (MSK).
A rigid bronchoscopy allows your doctor to see the inside of the airways leading to your lungs. During a rigid bronchoscopy, your doctor can control bleeding, reduce the size of a tumor, place a stent, remove foreign objects, and take biopsies (tissue samples), as necessary. A rigid bronchoscopy usually takes 60 to 90 minutes, although you will be in the hospital for most of the day because you will have had general anesthesia. In most cases, you will be able to go home the same day.
If you have any head or neck problems, such as stiffness, dental issues, surgery or radiation to the head or neck, or if you have rheumatoid arthritis, be sure to tell your doctor.
30 Days Before Your Procedure
Your Presurgical Testing (PST) appointment
Within 30 days of your rigid bronchoscopy, you will have an appointment in Presurgical Testing (PST). Your doctor's office will arrange this for you. During this appointment you will meet with a nurse practitioner who works closely with anesthesiology staff (doctors and specialized nurses who give you medicine to sleep during surgery). Your nurse practitioner will review your medical and surgical history with you, including your medications. You will have tests, including an electrocardiogram (EKG) to check your heart rhythm, a chest x-ray, blood tests, and any other tests necessary to plan your care. Your nurse practitioner may also recommend you see other healthcare providers.
It is very helpful if you bring the following with you to your PST appointment:
- A list of all the medications you take
- Reports of any tests done outside of MSK, such as a cardiac stress test, echocardiogram, or carotid doppler study
- The name and telephone number of your doctor(s)
During your PST appointment, your nurse practitioner will tell you which medications you should take the morning of your procedure. Use the space below to write them down.
10 Days Before Your Procedure
You will need to stop taking some medications 10 days before your procedure. Your nurse will give you an information sheet called Common Medicines Containing Aspirin and Other Non Steroidal Anti-inflammatory Medicines which contains important information about these medications, and what you can take instead.
There are some medications that you may need to talk with your doctor about before your procedure. For example:
- If you take medication to thin your blood, ask the doctor who prescribes it for you if you should stop taking it. Some examples are warfarin (Coumadin®), dalteparin (Fragmin®), heparin, aspirin, tinzaparin (Innohep®), enoxaparin (Lovenox®), clopidogrel (Plavix®), fonadparinux (Arixtra®), dabigatan (Pradaxa®), and cilostazol (Pletal®). Do not stop taking these medications without speaking to your doctor first.
- If you take insulin or other medications for diabetes, you may need to change the dose. Ask the doctor who prescribes this medicine for you what you should do the day before and the morning of your procedure.
Arrange for someone to take you home
You must have someone 18 years or older take you home after your procedure. Please call one of the agencies below if you do not have someone who can do this. They will help find someone to take you home.
Partners in Care (888) 735-8913
Caring People (877) 227-4649
The Day Before Your Procedure
A clerk from the Admitting Office will call you after 2:00 pm the day before your procedure. He or she will tell you what time you should arrive at the hospital for your procedure. If you are scheduled for your procedure on a Monday, you will be called on the Friday before. If you do not receive a call by 7:00 pm, please call (212) 639-5014.
If you need to cancel your procedure for any reason please call the doctor who scheduled it for you.
Do not eat or drink anything after midnight the night before your surgery.
This includes water, gum, and hard candy.
The Day of Your Procedure
Things to remember
- Do not eat or drink anything the morning of your surgery. This includes water, gum, and hard candy.
- Take only the medicines your doctor told you to take the morning of your procedure. You may have written them down on the first page of this guide. Take them with a few sips of water.
- Do not put on any lotion, cream, powder, deodorant, make-up, or perfume.
- Remove any jewelry, including body piercings.
- Leave all valuables such as credit cards and jewelry at home.
- If you wear contacts wear your glasses instead.
What to bring with you
- A list of the medications you take at home
- Medications for breathing problems (such as inhalers) and/or medicines for chest pain
- A case for your glasses
- Your Health Care Proxy form, if you have completed one
Where to park
Parking at Memorial Sloan Kettering is available in the garage on East 66th Street between First and York Avenues. To reach the garage, enter East 66th Street from York Avenue. The garage is located about ¼ block toward First Avenue, on the right (north) side of the street. A tunnel connects the garage to the hospital. There are also nearby commercial garages: 4 on East 69th Street between First and Second Avenues and 3 on East 65th Street between First and Second Avenues. For questions about pricing, call (212) 639-2338.
What to expect
Once you arrive at the hospital, doctors, nurses, and other staff members will ask you to state and spell your name and date of birth many times. This is for your safety. Patients with the same or similar names may be having procedures on the same day.
You'll be asked to change into a hospital gown, and remove dentures, prosthesis, and eyeglasses, if you have any. Your doctor will review the procedure with you, and your anesthesiologist will talk with you about your health history and place an intravenous (IV) catheter into a vein, usually in your hand or arm. Your nurse will check your heart rate, blood pressure, breathing, and temperature. Your healthcare team is available to answer any questions you have. When it's time for your procedure, you will be brought into the operating room.
Once you're in the operating room, you will be attached to equipment to monitor your heart, breathing, and blood pressure. You will also receive oxygen through your nose or mouth. You will receive medicine to make you sleepy through your IV. Once you're asleep, your doctor will insert a bronchoscope (a tube-like instrument with a small camera) into your mouth. It is gently moved down the back of your throat and through the large and small airways leading into your lungs (see figure). If necessary, your doctor will use ultrasound or fluoroscopy (live x-ray) during your procedure.
After Your Procedure
In the recovery room
You will wake up in the recovery room. Your nurse will continue to monitor your heart, breathing, and blood pressure. You might feel numbness in your throat. This is from medication used to make you more comfortable and reduce coughing, and it will go away as you wake up. You may have a chest x-ray. This is to make sure your lung was not punctured if you had a lung biopsy. This type of injury is rare.
Once you are fully awake, your nurse will give you a drink and a light snack, then remove your IV. Your doctor may talk with you and the person taking you home after your procedure. Your nurse will explain your discharge instructions to both you before you leave.
- You might have a sore throat for 1 or 2 days. Throat lozenges, ice chips, and eating soft foods can help. You should avoid spicy foods and smoking.
- You might see streaks of blood when you cough. This is expected. However, call your doctor's office if you cough up more than 1 teaspoon of blood.
- A nurse will contact you the next day to ask how you are doing.
- If tests were done during the bronchoscopy, call your doctor's office in a few days to get the results.
- If you were instructed to stop taking any medications before your procedure, ask your doctor when it is ok to resume taking them.
- You are able to resume your usual activities after your procedure.
- If your doctor placed a stent, you will be given instructions explaining how to take care of it.
- If you need any additional equipment, such as nebulizer, it will be ordered through your doctor's office.
Call Your Doctor or Nurse If You Have Any of the Following:
- A temperature of 101° F (38.3° C) or greater
- Difficulty breathing or shortness of breath
- Chest pain or a feeling of pressure in your chest
- Cough up more than a teaspoon of blood
- Severe pain, or pain for longer than 2 days