Bronchoscopes


Categories: INSTRUMENTARIUM
Sources: 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.





;