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Bronchoscopes





Category: INSTRUMENTARIUM
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery

The regular bronchoscope is a hollow brass tube
slanted at its distal end, and having a handle at its proximal or
ocular extremity. An auxiliary canal on its under surface contains
the light carrier, the electric bulb of which is situated in a recess
in the beveled distal end of the tube. Numerous perforations in the
distal part of the tube allow air to enter from other bronchi when the
tube-mouth is inserted into one whose aerating function may be
impaired. The accessory tube on the upper surface of the bronchoscope
ends within the lumen of the bronchoscope, and is used for the
insufflation of oxygen or anesthetics, (Fig. 2, A, B, C, D).

For certain work such as drainage of pulmonary abscesses, the lavage
treatment of bronchiectasis and for foreign-body or other cases with
abundant secretions, a drainage-bronchoscope is useful The drainage
canal may be on top, or on the under surface next to the light-carrier
canal. For ordinary work, however, secretion in the bronchus is best
removed by sponge-pumping (Q.V.) which at the same time cleans the
lamp. The drainage bronchoscope may be used in any case in which the very
slightly-greater area of cross section is no disadvantage; but in
children the added bulk is usually objectionable, and in cases of
recent foreign-body, secretions are not troublesome.

As before mentioned, the lower air passages will not tolerate
dilatation; therefore, it is necessary never to use tubes larger than
the size of the passages to be examined. Four sizes are sufficient
for any possible case, from a newborn infant to the largest adult.
For infants under one year, the proper tube is the 4 mm. by 30 cm.;
the child's size, 5 mm. by 30 cm., is used for children aged from one
to five years. For children six years or over, the 7 mm. by 40 cm.
bronchoscope (the adolescent size) can be used unless the smaller
bronchi are to be explored. The adult bronchoscope measures 9 mm.
by 40 cm.

The author occasionally uses special sizes, 5 mm. x 45 cm., 6 mm. x 35
cm., 8 mm. x 40 cm.





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