Bronchoscopy Procedure — Explained Step by Step

The part of the procedure where the bronchoscope is actually in your airways usually takes about 20 to 45 minutes, depending on what the doctor needs to look at and how many samples are taken. However, you should plan for a few hours at the hospital overall. This covers your check-in and preparation, the numbing and light sedation, the bronchoscopy itself, and then a recovery period of one to two hours while the sedation wears off. A straightforward look-and-sample bronchoscopy is at the shorter end, while an EBUS that samples lymph nodes can take a little longer. Your team will give you a clearer time estimate once they know the exact plan for your procedure.

A bronchoscopy is generally not painful, though it can feel a little strange. Before it starts, a local anaesthetic numbs your nose and throat, and most people are given light sedation to help them stay relaxed. The airways themselves have very few pain nerves, so taking samples or a biopsy does not usually hurt. You may feel some pressure, an urge to cough as the tube passes, or a tickling sensation, but these settle quickly. Many people remember little of the procedure afterwards because of the sedation. If you are anxious about discomfort, tell your team beforehand — they can talk you through exactly what you will feel and adjust your sedation to keep you comfortable.

For a flexible bronchoscopy, most people are awake but drowsy. You are given light or moderate sedation through a small cannula in your hand, which keeps you calm and relaxed without putting you fully to sleep. You can still breathe on your own and follow simple instructions, but you often remember little of the procedure afterwards. In some situations — for example a longer or more complex procedure, or for a rigid bronchoscopy — a general anaesthetic may be used instead, so you are fully asleep. Your doctor will explain which type of sedation is planned for you and why, so there are no surprises on the day.

You will usually be asked to fast beforehand — typically no food for around six hours, with only small sips of water allowed up to a couple of hours before — so your stomach is empty for sedation. Tell your team about all your medicines, especially blood thinners, diabetes medicines, and inhalers, as some may need to be paused or adjusted. Mention any allergies, bleeding problems, or heart and lung conditions. Because sedation is used, you must arrange for someone to take you home, and you should not drive, operate machinery, or sign important documents that day. Plan to rest afterwards rather than returning straight to work. If anything is unclear, ask your team before the day of the procedure.

A bronchoscopy helps diagnose a wide range of lung and airway conditions. It is often used to investigate a shadow or spot seen on a chest X-ray or CT scan, to find the cause of coughing up blood, or to look into a persistent cough or repeated chest infection. In the context of bronchoscopy lung cancer checks, it lets the doctor see suspicious areas directly and take biopsies, washings, or brushings to confirm whether cells are cancerous or benign. Using ultrasound guidance (EBUS), it can also sample lymph nodes in the chest, which helps with accurate staging. Beyond cancer, it can diagnose infections, inflammation, and airway narrowing, and sometimes treat problems such as clearing a blockage.

A bronchoscopy is a safe and routine procedure, and serious complications are uncommon. The most common after-effects are minor and short-lived: a sore or numb throat, a hoarse voice, and a mild cough. If a biopsy is taken, you may notice a little blood-streaked phlegm for a day or so, which is normal. Less often, there can be a small amount of bleeding, a temporary drop in oxygen, or a mild fever afterwards. Very rarely, a small air leak from the lung (pneumothorax) can occur, especially after certain biopsies. Your team watches closely throughout and tells you exactly which symptoms — such as heavy bleeding, severe breathlessness, or chest pain — to report once you are home.

Recovery from a flexible bronchoscopy is usually quick. Straight afterwards, you rest in a recovery area for about one to two hours while the sedation wears off. Your throat may feel numb or slightly sore, so you wait until your normal swallow returns before eating or drinking. Because of the sedation, you should not drive or work for the rest of the day and should have someone with you at home. Most people feel back to normal by the next day, with any mild cough or sore throat settling on its own. If a biopsy was taken, a little blood-streaked phlegm for a day is expected. Your team will tell you when you can return to your usual routine.

Some findings can be shared soon after the procedure, because the doctor can see the lining of your airways directly during the bronchoscopy and may describe what they noticed once you are awake enough to talk. However, the detailed results from any biopsies, washings, or brushings take a few days, as these samples need to be examined in the laboratory by a pathologist. At CION, your samples and scans are discussed by a tumour board — a panel of specialists who agree on the plan together — so the next step is decided by a team, not a single opinion. You will then sit with your doctor in an unhurried consultation to go through what the results mean and what, if anything, happens next.