At a glance
Bronchoscopy is a procedure in which a doctor passes a thin, flexible tube called a bronchoscope through the nose or mouth, down the throat, and into the airways of the lungs to see them directly.
The bronchoscope carries a small camera and a light at its tip, sending live images to a screen the doctor watches in real time. This lets the doctor inspect the voice box (larynx), the windpipe (trachea), and the branching airways (bronchi) for anything that looks abnormal. When needed, the same tube can pass tiny instruments to collect a tissue sample, clear a blockage, or deliver a treatment directly to the airway.
Medical Condition
Doctors order bronchoscopy when they need to look inside the airways or lungs for a cause that imaging tests such as a chest X-ray or CT scan alone cannot fully explain.
- A persistent cough, especially one that brings up blood (haemoptysis)
- A shadow, mass, or unusual finding seen on a chest X-ray or CT scan
- Suspected lung infection that has not responded to standard treatment
- Diagnosis or staging of lung cancer
- Narrowing or blockage of a major airway
- Inhaling a foreign object that has lodged in the airway
- Chronic hoarseness or unexplained breathing difficulty
- Collection of fluid or mucus that needs to be drained or sampled
- Monitoring after a lung transplant for signs of rejection or infection
Bronchoscopy is usually not suitable when the patient cannot safely receive sedation, when blood clotting is severely impaired, or when breathing is already so compromised that the procedure would carry unacceptable risk. A respiratory specialist will weigh these factors before proceeding.
Risks & Complications
Bronchoscopy is generally well tolerated, but like any invasive procedure it carries a small chance of complications, most of which are minor and short-lived.
- Sore throat, hoarseness, or mild discomfort in the airway after the tube is removed
- Temporary low oxygen levels during the procedure, managed with supplemental oxygen
- Bleeding, particularly if a tissue sample (biopsy) is taken
- Fever or a short-lived chest infection following the procedure
- A collapsed lung (pneumothorax), a small pocket of air outside the lung, which is more likely if a biopsy reaches deep into lung tissue
- Reaction to the sedative or local anaesthetic used to numb the throat
- Irregular heartbeat (arrhythmia) during the procedure, usually brief and self-correcting
- Rarely, significant bleeding or respiratory failure requiring urgent treatment
Preparation & Procedure
In the hours before bronchoscopy, the stomach needs to be empty so that nothing can travel up into the airway if the patient gags or vomits. Most hospitals ask patients to stop eating solid food at least six hours before and to stop drinking clear fluids at least two hours before, though the exact cut-off your team sets may differ.
Blood thinners and antiplatelet medicines are usually paused several days in advance to reduce the risk of bleeding, especially if a biopsy is planned. Patients who use an inhaler for asthma or chronic obstructive pulmonary disease (COPD, a long-term condition that narrows the airways) typically continue using it as normal. The prescribing doctor will give clear guidance on which medicines to pause and which to continue.
Before the procedure, the care team generally runs a set of preparatory tests. These commonly include a blood test to check clotting ability, a chest X-ray or recent CT scan for reference, and a measurement of how well the lungs are working (spirometry). An electrocardiogram (EKG, a recording of the heart's electrical activity) may also be done for older patients or those with heart conditions.
On the day, the procedure usually unfolds in the following steps.
- A nurse checks vital signs and places a small needle (cannula) in a vein in the arm for delivering medication.
- A local anaesthetic spray is applied to the nose and throat to reduce the gag reflex and numb the airway.
- A sedative is given through the cannula to keep the patient calm and relaxed. In some cases, the patient is given a light general anaesthetic instead.
- Oxygen is delivered through a clip on the finger or a probe monitors oxygen levels throughout.
- The doctor gently passes the bronchoscope through one nostril or the mouth and advances it to the vocal cords, into the trachea, and down into the bronchi.
- The doctor inspects the airway walls carefully and notes any redness, swelling, narrowing, or growth.
- If needed, a small brush, needle, or forceps is passed through the bronchoscope to collect tissue or fluid samples, clear secretions, or place a stent (a small tube that holds an airway open).
- The bronchoscope is withdrawn slowly, and the patient is moved to a recovery area.
Aftercare
After bronchoscopy, patients spend time in a monitored recovery area until the sedative wears off and the throat's normal sensation returns, which usually takes one to two hours. Most patients go home the same day, though an overnight stay may be planned if a biopsy was taken from deep in the lung or if a therapeutic step such as placing a stent was performed.
- Eating and drinking are held back until the throat numbing has fully worn off, because swallowing before then carries a risk of inhaling liquid.
- A responsible adult should accompany the patient home and stay with them for the rest of the day, as the sedative affects judgement and coordination.
- Driving and operating machinery are off limits for the remainder of the day after sedation.
- A mild sore throat, slight hoarseness, or small flecks of blood in saliva or mucus are normal for a day or two after the procedure.
- The care team should be contacted promptly if the patient experiences fever, worsening shortness of breath, chest pain, or coughing up more than a small amount of blood.
- Biopsy results typically take several days to come back from the laboratory; the doctor will arrange a follow-up appointment to discuss findings and next steps.
- Blood thinners that were paused before the procedure are restarted on the doctor's advice, usually once the risk of bleeding from the biopsy site has passed.
- Lifestyle adjustments after bronchoscopy depend on the underlying diagnosis; the respiratory specialist will outline any longer-term changes at the follow-up visit.
Cost & What Determines It
The price of bronchoscopy varies widely from one hospital or country to another, and even between patients at the same hospital, because the procedure can range from a straightforward inspection of the airway to a complex therapeutic intervention lasting much longer and requiring specialised equipment.
- Purpose of the procedure: a diagnostic bronchoscopy to look and take a simple biopsy costs less than a therapeutic bronchoscopy that includes removing a tumour, clearing a severe blockage, or placing a stent.
- Hospital class and setting: a private specialist centre or academic medical centre charges more than a general district hospital.
- Country of treatment: healthcare labour costs, facility fees, and regulatory environments differ significantly between countries.
- Type of sedation used: local anaesthetic with mild sedation is less expensive than a full general anaesthetic with an anaesthetist present throughout.
- Equipment and devices: a rigid bronchoscope (a stiffer tube used for more complex airway work) or an endobronchial ultrasound (EBUS, a bronchoscope fitted with an ultrasound probe to guide needle biopsies of lymph nodes) adds to the cost.
- Number and type of samples: more biopsy samples or specialised laboratory analyses such as genetic testing of tumour tissue increase pathology fees.
- Length of stay: day-case bronchoscopy is billed differently from one that requires an overnight admission or an ICU stay.
- Pre-procedure tests: spirometry, CT scan, blood clotting panel, and EKG are typically billed separately unless bundled.
Many hospitals offer a packaged price that covers the bronchoscopy itself, the recovery room, standard nursing care, and basic consumables. Anaesthesia, pathology fees for biopsy analysis, any implants such as stents, imaging done on the same day, and specialist consultation fees are often invoiced separately. Asking for a detailed written quote before travel helps avoid unexpected charges.
BPJS Kesehatan and most Indonesian private insurance policies do not reimburse treatment carried out abroad, so patients travelling overseas for bronchoscopy typically pay out of pocket or rely on an international health insurance plan that specifically covers overseas procedures. Before booking, request a written cost estimate from the hospital that itemises every component, including what happens if the procedure uncovers a finding that requires immediate additional treatment.
Frequently Asked Questions
Does bronchoscopy hurt?
Most patients feel pressure or an urge to cough rather than sharp pain during bronchoscopy. A local anaesthetic (numbing spray) is applied to the throat, and a sedative is usually given through a drip so you feel drowsy and relaxed. Some mild soreness in the throat or hoarseness may linger for a day or two afterwards.
How long does a bronchoscopy take?
The procedure itself usually takes between 20 and 45 minutes, though the total time in the unit is longer because you need preparation beforehand and a recovery period after the sedative wears off. Plan for around three to four hours at the facility in total.
How do I prepare for bronchoscopy, and do I need to fast?
Yes, you will typically be asked to stop eating and drinking for several hours before the procedure, because sedation is used and having an empty stomach reduces the risk of complications. Your doctor will also review any blood thinners or other regular medicines you take, and some may need to be paused beforehand. Follow the specific instructions your hospital gives you.
How much does bronchoscopy cost?
The cost varies depending on whether the bronchoscopy is done for diagnosis only or includes a therapeutic step such as removing a blockage or taking a tissue sample (biopsy), as well as the hospital class and whether an overnight stay is needed. A written estimate from the hospital will give you the most accurate figure for your situation.
This page is general information, not a substitute for medical advice. Every case is different. Your doctor decides what is right for you.
