Concierge chest procedures · London
Private bronchoscopy in London, from flexible day-case to EBUS-TBNA and rigid theatre lists.
A same-week concierge route to consultant chest physicians and interventional pulmonologists for the full spectrum of airway diagnostics and therapeutics. Bookings within one working day.
Procedures
One name, six very different procedures.
The right technique depends on the question being asked. We match you to the operator whose bread and butter is your case.
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Diagnostic flexible bronchoscopy
A fibre-optic scope passed through the nose or mouth, past the larynx, into the trachea and bronchial tree. Conscious sedation with midazolam and fentanyl plus topical lidocaine 4%. Twenty to thirty minutes as a day case. Used for visualisation, biopsy, brush cytology, bronchoalveolar lavage (BAL) and foreign body retrieval.
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EBUS-TBNA
Endobronchial ultrasound with a curvilinear probe and real-time ultrasound-guided transbronchial needle aspiration of hilar and mediastinal lymph nodes. The mainstay of non-surgical lung cancer staging (N1, N2, N3) and the first-line node biopsy for sarcoidosis. Select centres offer rapid on-site cytology (ROSE) for immediate adequacy checks.
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Navigational bronchoscopy
Electromagnetic navigation (ENB, SuperDimension) or robotic platforms (Ion by Intuitive, Monarch by Johnson and Johnson) to reach peripheral pulmonary nodules that flexible scopes cannot see. Often combined with cone-beam CT for tissue confirmation of small nodules picked up on lung cancer screening or surveillance imaging.
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Transbronchial cryobiopsy
A cryoprobe freezes and lifts a larger tissue sample than forceps biopsy, giving multidisciplinary teams the histology they need to characterise interstitial lung disease (ILD) without a surgical lung biopsy in many cases.
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Therapeutic bronchoscopy
Argon plasma coagulation (APC), Nd:YAG laser, cryotherapy for tumour ablation, endobronchial brachytherapy, self-expanding metal stents (SEMS) for malignant or benign airway stenosis, and bronchial thermoplasty for severe asthma. Endobronchial valves treat selected emphysema.
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Rigid bronchoscopy
Performed under general anaesthetic in theatre for large foreign body removal, massive haemoptysis, complex stent insertion and tumour debulking. Requires an interventional pulmonologist and anaesthetic team; typically an overnight stay.
When it is used
The clinical questions bronchoscopy answers.
If your consultant has suggested any of the following, this is the diagnostic pathway.
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Haemoptysis workup
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Persistent unexplained cough over eight weeks with abnormal imaging
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Suspicious CT nodule needing tissue
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Hilar or mediastinal lymphadenopathy (EBUS-TBNA for lung cancer staging or sarcoidosis)
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Unexplained pulmonary infiltrate
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Suspected infection in the immunocompromised patient
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Interstitial lung disease requiring cryobiopsy
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Tracheal or bronchial stenosis assessment
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Foreign body retrieval
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Bronchial thermoplasty for severe asthma
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Endobronchial valve placement for emphysema
Preparation
The four things to get right before the day.
We send a written checklist and speak to your prescriber for anticoagulation.
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Fasting
Nil by mouth for four to six hours before the procedure. Small sips of water permitted up to two hours before.
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Anticoagulation
Dual antiplatelet therapy usually held for seven days. Warfarin bridged as per your cardiologist. Direct oral anticoagulants held twenty-four to forty-eight hours before, depending on renal function.
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Airway anaesthesia
Nebulised lidocaine 4% before sedation, topped up during the procedure. Numbs the vocal cords and airway so the scope is comfortable.
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Escort home
Sedation means no driving, operating machinery or signing legal documents for twenty-four hours. A responsible adult should collect you.
Safety
A very safe procedure, honestly described.
Serious complications are rare. Here is what we monitor for.
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Minor haemoptysis
Small amounts of blood are common after biopsy and settle quickly. Significant bleeding is under one per cent.
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Pneumothorax
Under one per cent for standard flexible bronchoscopy. Four to eight per cent with transbronchial lung biopsy or cryobiopsy. A post-procedure chest X-ray checks for it.
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Hypoxia and arrhythmia
Managed with continuous SpO2, ECG and blood pressure monitoring throughout, with supplemental oxygen as required.
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Sedation reaction
Reversal agents (flumazenil, naloxone) are always available. Recovery in a monitored bay for one to two hours.
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Laryngospasm
Rare and self-limiting with the airway team present. More common in rigid bronchoscopy, where the anaesthetist manages it directly.
Indicative pricing
Honest ranges across the London panel.
Prices vary by operator, sedation team, cytology and stent hardware. Firm quotes within one working day.
| Procedure | Indicative self-pay range |
|---|---|
| Diagnostic flexible bronchoscopy | £1,800 to £3,500 |
| EBUS-TBNA (with cytology) | £3,500 to £6,500 |
| Navigational bronchoscopy (ENB or robotic) | £4,500 to £8,500 |
| Transbronchial cryobiopsy for ILD | £4,500 to £7,500 |
| Therapeutic bronchoscopy (APC or stent) | £5,500 to £12,500 |
London centres
The chest units we route to.
A small panel with the operator volumes and anaesthetic cover to do this well.
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Royal Brompton Private Chest
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Chelsea and Westminster Private Respiratory
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HCA The Wellington Chest
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London Bridge Respiratory
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One Welbeck Chest Imaging and Endoscopy
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Cromwell Hospital (BUPA) Chest
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Guy’s and St Thomas’ Private Chest
Related pages
Explore the surrounding pathway.
Frequently asked
What patients ask before booking.
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How long does a private bronchoscopy take?
A diagnostic flexible bronchoscopy runs twenty to thirty minutes, with an hour or two in recovery before you go home. EBUS-TBNA adds fifteen to thirty minutes. Rigid bronchoscopy under general anaesthetic typically takes forty-five to ninety minutes, with an overnight stay.
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Will I be asleep for the procedure?
Flexible bronchoscopy is done under conscious sedation with midazolam and fentanyl plus topical lidocaine. You are relaxed and comfortable, often with no memory of it, but breathing on your own. Rigid bronchoscopy needs a full general anaesthetic in theatre.
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How accurate is EBUS-TBNA for lung cancer staging?
Sensitivity for mediastinal nodal staging in non-small cell lung cancer is around 85 to 95 per cent in experienced hands, with a very low complication rate. It has largely replaced mediastinoscopy as the first-line staging test.
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What do I do about my blood thinners?
Dual antiplatelet therapy is usually paused for seven days. Warfarin is bridged with heparin per your cardiologist. DOACs are held twenty-four to forty-eight hours before. Aspirin monotherapy can usually continue for diagnostic work. We coordinate the plan with your prescriber before booking.
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How soon do I get results?
Visual findings and BAL cell counts are available the same day. Cytology from EBUS-TBNA and forceps biopsy takes two to five working days. Microbiology cultures take longer. ROSE at select London centres gives an on-the-spot adequacy check for lymph node samples.
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Can I have this on private medical insurance?
Bupa, AXA Health, Vitality, Aviva, WPA, Cigna and Healix all recognise bronchoscopy and EBUS-TBNA when clinically indicated and pre-authorised. Complex therapeutic cases and cryobiopsy usually need consultant-to-insurer discussion, which we handle for you.
Ready to book?
A consultant chest physician, matched to your case, within one working day.
Diagnostic flexible, EBUS-TBNA, navigational, cryobiopsy, therapeutic and rigid bronchoscopy across the London panel.