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6 - Anatomy and Care of the Bronchoscope

Published online by Cambridge University Press:  07 July 2009

By
Robert Garland
Edited by
Armin Ernst
Armin Ernst
Affiliation:
Harvard Medical School/Beth Israel Deaconess Medical Center
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Summary

The flexible bronchoscope has undergone many technological advances since it was first introduced more than 40 years ago [1]. But, despite these advances in imaging and ease of use, it remains a fragile piece of equipment and susceptible to damage [2]. If improvements can be made to the quality of the image and the size of the working channel without compromising the overall diameter of the instrument, why can't significant improvements be made to the durability of the bronchoscope? Very simply put, there is so much technology stuffed into such a small compartment that even slight trauma to the instrument can be devastating.

It is truly remarkable that this equipment can perform all the functions that it does when you consider the difficulties in engineering such a small diameter instrument. Let's consider the challenges we must overcome in developing the flexible bronchoscopes that are available today.

CHALLENGES AND BASIC REQUIREMENTS OF THE BRONCHOSCOPE

The bronchoscope must accomplish several feats with some challenging obstacles that it must overcome:

  • It must be small enough to fit into the airway and still provide space for breathing.

  • The airway does not have any illumination, so we must provide artificial light to see where we are going.

  • There are bifurcations in the airway, so we need a mechanism for steering the instrument.

  • The airway can be obstructed with fluid or blood, so we must have a way to clear those to continue our journey.

Type
Chapter
Information
Introduction to Bronchoscopy , pp. 62 - 70
Publisher: Cambridge University Press
Print publication year: 2009

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References

Ikeda, S, Yanai, N, Ishikawa, S.Flexible bronchofiberscope. Keio J Med. 1968;17:1–16.CrossRefGoogle ScholarPubMed
Mehta, AC, Curtis, PS, Scalzitti, ML, Meeker, DP. The high price of bronchoscopy. Maintenance and repair of the flexible fiberoptic bronchoscope. Chest. 1990;98:448–454.CrossRefGoogle Scholar
Olympus BF-1T180 (Evis Bronchoscopy Systems Operation Manual) Olympus America Inc., Center Valley, PA, 2007.
Olympus CV-180 Evis Bronchoscopy Systems Operation Manual). Olympus America Inc., Center Valley, PA, 2007.
Karl Stoz Endoscopy-America Inc. Non-Invasive Troubleshooting of Endoscopic Video Systems. Karl Storz Endoscopy-America Inc., Culver City, CA, 1999.
Olympus America Inc. How to Prevent Instrument Malfunctions for Gastrointestinal and Bronchial Endoscopes. Olympus America Inc., Center Valley, PA, 2004.
Mehta, A, Siddiqi, A, Walsh, A. Prevention of damage and maintenance of a flexible bronchoscope. In: Beamis, J, Mathur, P, eds. Interventional Pulmonology, Vol. 2. New York: McGraw Hill; 1999;9–16.Google Scholar
Lee, FYW. Care and maintenance of the flexible bronchoscope. In: SH, Feinsilver, AM, Fein, eds. Textbook of Bronchoscopy. Baltimore: Williams and Wilkins; 1995:100–108.Google Scholar
Prakash, UBS. Bronchoscopy unit, expertise, equipment and personnel. In: Bollinger, CT, Mathur, PN, eds. Interventional Bronchoscopy. Progress in Respiratory Research. Vol. 30. Basel: Karger; 2000;31–43.CrossRefGoogle Scholar
Olympus BF1T180 (Evis Bronchoscopy Systems Reprocessing Manual). Olympus America Inc., Center Valley, PA, 2007.
Culver, D, Minai, O, Gordon, S, Mehta, A. Infection control and radiation safety in the bronchoscopy suite. In: Wang, K, Mehta, A, Turner, J, eds. Flexible Bronchoscopy. 2nd ed. Malden, MA : Blackwell Publishing; 2004;3:9–25.Google Scholar
Mehta, A, Prakash, U, Garland, R, et al. American College of Chest Physicians and American Association for Bronchology Consensus Statement. Prevention of flexible bronchoscopy-associated infection. Chest. 2005;128:1742–1755.CrossRefGoogle Scholar
Kirkpatrick, MB, Smith, JR, Hoffman, PJ. Bronchoscope damage and repair costs: results of a regional postal survey. Respir Care. 1992;37:1256–1259.Google ScholarPubMed
Stelck, M, Kulas, M, Mehta, A. Maintenance of the bronchoscope and bronchoscopy equipment. In: Prakash, U, ed. Bronchoscopy. New York: Raven Press; 1994;28:381–391.Google Scholar
Lunn, W, Garland, R, Gryniuk, L, Smith, L, Feller-Kopman, D, Ernst, A. Reducing maintenance and repair costs in an interventional pulmonology program. Chest. 2005;127:1382–1387.Google Scholar

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