Private bronchoscopy in London, from flexible day-case to EBUS-TBNA and rigid theatre lists.

• 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.

• 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.

• 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.

• 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.

• 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.

• 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.

• Haemoptysis workup

• Persistent unexplained cough over eight weeks with abnormal imaging

• Suspicious CT nodule needing tissue

• Hilar or mediastinal lymphadenopathy (EBUS-TBNA for lung cancer staging or sarcoidosis)

• Unexplained pulmonary infiltrate

• Suspected infection in the immunocompromised patient

• Interstitial lung disease requiring cryobiopsy

• Tracheal or bronchial stenosis assessment

• Foreign body retrieval

• Bronchial thermoplasty for severe asthma

• Endobronchial valve placement for emphysema

• Fasting

  Nil by mouth for four to six hours before the procedure. Small sips of water permitted up to two hours before.

• 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.

• Airway anaesthesia

  Nebulised lidocaine 4% before sedation, topped up during the procedure. Numbs the vocal cords and airway so the scope is comfortable.

• Escort home

  Sedation means no driving, operating machinery or signing legal documents for twenty-four hours. A responsible adult should collect you.

• Minor haemoptysis

  Small amounts of blood are common after biopsy and settle quickly. Significant bleeding is under one per cent.

• 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.

• Hypoxia and arrhythmia

  Managed with continuous SpO2, ECG and blood pressure monitoring throughout, with supplemental oxygen as required.

• Sedation reaction

  Reversal agents (flumazenil, naloxone) are always available. Recovery in a monitored bay for one to two hours.

• Laryngospasm

  Rare and self-limiting with the airway team present. More common in rigid bronchoscopy, where the anaesthetist manages it directly.

• Royal Brompton Private Chest

• Chelsea and Westminster Private Respiratory

• HCA The Wellington Chest

• London Bridge Respiratory

• One Welbeck Chest Imaging and Endoscopy

• Cromwell Hospital (BUPA) Chest

• Guy’s and St Thomas’ Private Chest

Related pages

Explore the surrounding pathway.

• Spirometry and lung function
• Private CT scan
• PET-CT
• Bronchial thermoplasty
• Asthma biologics clinic
• Lung cancer
• Asthma