Rigid Bronchoscopy: Indications and Techniques

p c t b p p m t v a v s t w o Rigid bronchoscopy is an important procedure for the thoracic surgeon to master. Its utility has been evident since the 1890s when Gustav Killian removed a foreign body from a patient’s right main bronchus and Chevalier Jackson developed his own endoscopes with distal illumination.1,2 Today’s rod-lens telescope was developed by Harold Hopkins in England and is the basic telescope inserted through the rigid bronchoscope. Karl Storz modified this technology with a cold illumination source for his rigid bronchoscope in the 1950s.3 The modern rigid bronchoscope is used for the diagnosis and treatment of benign and malignant pathology of the central airways. Indications for use include, but are not limited to, foreign body retrieval, obtaining hemostasis and removing blood clots in patients with hemoptysis, and relieving airway obstruction from tumors or intubationrelated stenoses. When necessary, rigid bronchoscopy can facilitate the placement of tracheal or bronchial stents. Endoluminal therapies, such as laser treatment, argon plasma coagulation, and debriding instruments, are best used under the protection of a rigid bronchoscope. Rigid bronchoscopy is best used in combination with other modalities, including radiologic studies, such as thin-slice computed tomography scans, flexible bronchoscopy, esophagoscopy, and laryngoscopy. Although they come in various types and sizes, the overall construction of the rigid bronchoscope is typically uniform: a