The bronchoscope is passed through the nose, and the upper airways are closely examined. The vocal cords are then examined and additional local anaesthetic is applied to the cords. This is often the worst part of the procedure for the patient. The trachea is entered and both sides of the lung are inspected in detail. Any secretions that are present are cleared via suctioning through the bronchoscope.
Sterile fluid is instilled into the lung and then is suctioned back into a collection container.
The specimens thus obtained are referred to as bronchial washings or bronchoalveolar lavage. In most cases biopsies of the lung will be taken. This involves passing a biopsy forceps through the suction channel of the bronchoscope out into the lung and taking very small pieces of lung tissue by opening and closing the biopsy forceps. Complications of taking biopsies include bleeding and a pneumothorax. A pneumothorax refers to the collection of air between the lung and the chest wall.