About Your Rigid Bronchoscopy

This information will help you prepare for your rigid bronchoscopy procedure at Memorial Sloan Kettering (MSK).

A bronchoscopy is a procedure that allows your doctor to look inside your lung airways using a bronchoscope (a tube with a camera). The bronchoscope is placed in your mouth or nose and moved down your throat and trachea (windpipe), into your airways.

During your rigid bronchoscopy, your doctor can control bleeding, reduce the size of a tumor, place a stent (a hollow tube that keeps your airway open), remove foreign objects, and take biopsies (tissue samples), as necessary. If you may need a stent, ask your nurse for the resource Tracheal or Bronchial Stent Placement.

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 before your procedure.

Before Your Procedure

Presurgical testing

Within 30 days of your procedure, you will have an appointment for presurgical testing (PST). Your doctor’s office will schedule this for you.

During your appointment you will meet with a nurse practitioner who works closely with anesthesiology staff (doctors and specialized nurses who give you medication to sleep during surgery). Your nurse practitioner will review your medical and surgical history with you, including your medications. You will have tests done, 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.

Please 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).

Ask about your medications

You may need to stop taking some of your medications before your procedure. Review the information below carefully so you have time to discuss your medications with your doctor, if necessary.

If you take medication that affects the way your blood clots, ask the doctor performing your procedure what to do. The doctor’s contact information is listed at the end of this resource. Some examples of these medications are:

apixaban
(Eliquis®)
dalteparin
(Fragmin®)
meloxicam
(Mobic®)
ticagrelor
(Brilinta®)
aspirin
 
 
dipyridamole
(Persantine®)
 
nonsteroidal anti-inflammatory
drugs (NSAIDs) such as ibuprofen
(Advil®) or naproxen (Aleve®)
tinzaparin
(Innohep®)
 
celecoxib
(Celebrex®)
edoxaban
(Savaysa®)
pentoxifylline
(Trental®)
warfarin
(Coumadin®)
cilostazol
(Pletal®)
enoxaparin
(Lovenox®)
prasugrel
(Effient®)
 
clopidogrel
(Plavix®)
Fondaparinux
(Arixtra®)
rivaroxaban
(Xarelto®)
 
dabigatran
(Pradaxa®)
heparin
(shot under your skin)
sulfasalazine
(Azulfidine®, Sulfazine®)
 

Whether they recommend you stop taking it will depend on the reason you are taking it. Do not stop taking any of these medications without talking with your doctor.

  • If you take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil®) or naproxen (Aleve®), you may need to stop taking them 7 days before your procedure. For a list of medications in this category and which medications you can take instead, ask for the resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
  • If you take insulin or other medications for diabetes, you may need to change the dose before your procedure. Ask the doctor who prescribes your diabetes medication 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. If you don’t have anyone, call one of the agencies below. They will provide someone to accompany you home, however there is usually a charge for this service and you will also need to provide transportation.

In New York:

  • Partners in Care: 888-735-8913
  • Prime Care: 212-944-0244

In New York or New Jersey:

  • Caring People: 877-227-4649
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The Day Before Your Procedure

Note the time of your appointment

A clerk from the Admitting Office will call you after 2:00 pm the day before your procedure. They will tell you what time you should arrive at the hospital for your procedure. If your procedure is scheduled 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.

 
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The Day of Your Procedure

Between midnight and up until 2 hours before your scheduled arrival time, you may drink a total of 12 ounces of clear liquids (see Figure 1).

Figure 1. 12 ounces of clear liquid

Examples of clear liquids include:

  • Water
  • Clear broth, bouillon, or consommé (no particles of dried food or seasonings) 
  • Gelatin, such as Jell-O® 
  • Clear fruit juices (no pulp), such as white cranberry, white grape, or apple 
  • Soda, such as 7-Up®, Sprite®, ginger ale, seltzer, or Gatorade® 
  • Coffee or tea, without milk or cream 

Things to remember

  • Take the medications you were instructed to take the morning of your procedure 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 contact lenses, 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), chest pain, or both
  • A case for your glasses
  • Your Health Care Proxy form, if you have completed one

Where to park

Parking at MSK is available in the garage on East 66th Street between York and First Avenues. To reach the garage, turn onto East 66th Street from York Avenue. The garage is located about a quarter of a block in from York Avenue, on the right-hand (north) side of the street. There is a pedestrian tunnel that goes from the garage to the hospital. If you have questions about prices, call 212-639-2338.

There are also other garages located on East 69th Street between First and Second Avenues, East 67th Street between York and First Avenues, and East 65th Street between First and Second Avenues.

Where to go

Go to the Presurgical Center at 1275 York Avenue (between East 67th and East 68th Streets). This is the main building of MSK. Take the B elevator to the 6th floor.

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. People 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.

Figure 2. Inserting the bronchoscope

When it’s time for your procedure, you will be brought into the operating room and helped onto an exam table. You will be attached to equipment to monitor your heart rate, breathing, and blood pressure. You will also receive oxygen through your nose.

You will receive anesthesia (medication to make you sleep) through your IV.

Once you’re asleep, your doctor will insert the bronchoscope into your mouth. They will gently move it down the back of your throat and through the large and small airways leading into your lungs (see Figure 2). Your doctor may use a laser, electrocautery (electricity) or cryotherapy to heat, burn, or freeze the tumor or sites of bleeding inside your airways. They may use fluoroscopy (live x-ray) during your procedure for guidance. Your doctor may also place a stent inside your airways to keep them open. 

The rigid bronchoscopy usually takes 60 to 90 minutes.

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After Your Procedure

In the recovery room

You will wake up in the Post Anesthesia Care Unit (PACU). Your nurse will continue to monitor your heart rate, breathing, and blood pressure.

You may feel numbness in your throat. This is from medication used to make you more comfortable and reduce coughing, and it will go away shortly after you wake up. You may have a chest x-ray to make sure your lung was not punctured. This type of injury is rare.

Once you are fully awake, your nurse may give you a drink and a light snack, and remove your IV. Your doctor may talk with you and the person taking you home after your procedure.  If you stopped taking any medications before your procedure, ask your doctor when you can start taking them again.

Your nurse will explain your discharge instructions to both you and the person taking you home before you leave. If your doctor placed a stent, you will receive instructions on how to take care of it.

At home

  • You may 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 may cough up streaks of blood. This is expected. However, call your doctor’s office if you cough up more than 1 teaspoon of blood.
  • You may resume your usual activities after your procedure.
  • A nurse will contact you the next day to ask how you are doing.
  • If tests were done during your rigid bronchoscopy, call your doctor’s office in a few days to get the results.
  • If you need any additional equipment, such as nebulizer, it will be ordered through your doctor’s office.
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Call Your Doctor or Nurse if You:

  • Have a temperature of 101° F (38.3° C) or higher
  • Have difficulty breathing or shortness of breath
  • Have chest pain or a feeling of pressure in your chest
  • Cough up more than 1 teaspoon of blood
  • Have severe pain, or pain for longer than 2 days
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