Bronchoscope Health Dictionary

The use of a bronchoscope to visualise the interior of the bronchial tubes.... bronchoscopy

A visualising technique enabling the operator to examine the internal organs with the minimum of disturbance or damage to the tissues. The procedure has transformed the management of, for example, gastrointestinal disease. In chest disease, ?breoptic bronchoscopy has now replaced the rigid wide-bore metal tube which was previously used for examination of the tracheo-bronchial tree.

The principle of ?breoptics in medicine is that a light from a cold light source passes down a bundle of quartz ?bres in the endoscope to illuminate the lumen of the gastrointestinal tract or the bronchi. The re?ected light is returned to the observer’s eye via the image bundle which may contain up to 20,000 ?bres. The tip of the instrument can be angulated in both directions, and ?ngertip controls are provided for suction, air insu?ation and for water injection to clear the lens or the mucosa. The oesophagus, stomach and duodenum can be visualised; furthermore, visualisation of the pancreatic duct and direct endoscopic cannulation is now possible, as is visualisation of the bile duct. Fibreoptic colonoscopy can visualise the entire length of the colon and it is now possible to biopsy polyps or suspected carcinomas and to perform polypectomy.

The ?exible smaller ?breoptic bronchoscope has many advantages over the rigid tube, extending the range of view to all segmental bronchi and enabling biopsy of pulmonary parenchyma. Biopsy forceps can be directed well beyond the tip of the bronchoscope itself, and the more ?exible ?breoptic instrument causes less discomfort to the patient.

Fibreoptic laparoscopy is a valuable technique that allows the direct vizualisation of the abdominal contents: for example, the female pelvic organs, in order to detect the presence of suspected lesions (and, in certain cases, e?ect their subsequent removal); check on the development and position of the fetus; and test the patency of the Fallopian tubes.

(See also ENDOSCOPE; BRONCHOSCOPE; LARYNGOSCOPE; LAPAROSCOPE; COLONOSCOPE.)... fibreoptic endoscopy

n. failure of part of the lung to expand. This occurs when the cells lining the air sacs (alveoli) are too immature, as in premature babies, and unable to produce the wetting agent (surfactant) with which the surface tension between the alveolar walls is overcome. It also occurs when the larger bronchial tubes are blocked from within by retained secretions, inhaled foreign bodies, or bronchial cancers, or from without by enlarged lymph nodes, such as are found in patients with tuberculosis and lung cancers. The lung can usually be helped to expand by physiotherapy and removal of the internal block (if present) via a *bronchoscope, but prolonged atelectasis becomes irreversible.... atelectasis

(BAL) a method of obtaining cellular material from the lungs that is used particularly in the investigation and monitoring of interstitial lung disease and in the investigation of pulmonary infiltrates in immunosuppressed patients. A saline solution is infused into the lung, via a bronchoscope, and immediately removed. Examination of the cells in the lavage fluid may help to identify the cause of interstitial lung disease. The combination of cytological and microbiological examination can lead to a very high rate of diagnostic accuracy in such conditions as *Pneumocystis jiroveci pneumonia.... bronchoalveolar lavage

(PDT, photoradiation therapy, phototherapy, photochemotherapy) 1. a treatment for some types of superficial cancers. A light-sensitive agent (porfimer sodium [Photofrin] or temoporfin [Foscan]) is injected into the bloodstream and remains in cancer cells for a longer time than in normal cells. Exposure to laser radiation produces an active form of oxygen that destroys the treated cancer cells. The laser radiation can be directed through a fibreoptic bronchoscope into the airways, through a gastroscope into the oesophagus, or through a cystoscope into the bladder. PDT causes minimal damage to healthy tissue, but as it cannot pass through more than about 3 cm of tissue, it is restricted to treating tumours on or just under the skin or on the lining of internal organs. Photodynamic therapy makes the skin and eyes sensitive to light for six weeks or more after treatment. 2. a treatment for wet age-related *macular degeneration that involves the intravenous injection of a light-sensitive agent (verteporfin, Visudyne) which passes to the abnormal leaking blood vessels in the retina. The agent is activated when a cold laser light is directed at the macula, sealing the abnormal vessels and thus preventing further leakage and macular damage. The effect is to limit visual loss and stabilize vision.... photodynamic therapy