Bronchoscopes belong to a type of endoscopy medical devices used to study the inner airways of the lungs. An instrument is inserted into the airways, usually through the nose or mouth, or occasionally through a tracheostomy. Bronchoscopes are generally used for diagnostic purposes however sometimes also used for surgical procedures of the airways. Tracheostomy is generally done in order to get an unobstructed view of the whole respiratory system. Bronchoscope is commonly used to diagnose lung bleeding, tumors, inflammation, infections, foreign bodies, parasites and so on.
Most of the bronchoscopes are classified into rigid and flexible designs. Rigid designs are much older and employ metal parts to allow them to view trachea and the nearby major bronchi, whereas flexible designs allow for greater entrance as they employ flexible fiber optic cables that enable real-time video recording and related procedures. Bronchoscopes were first used reportedly in 1897 by Gustav Killian for an obstructive material removal procedure; the modern rigid bronchoscope is based on a 1920 modification done by Chevalier Jackson and Victor Negus who designed the same for bronchial inspection and surgical procedures.
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The flexible bronchoscope was invented by a Japanese inventor and medical practitioner, Shigeto Ikeda, in 1966 which are still in use. The flexible bronchoscope allowed for 180 degree flexibility and 120 degree extension allowing great maneuverability for the endoscope. Latest technology in flexible endoscope, employs video chips that can transmit video visuals to a monitor wirelessly or through the scope thereby reducing the thickness of the endoscope. However all the types of bronchoscopes have their respective advantages depending upon the nature of the medical condition.
Rigid bronchoscopes were designed keeping in mind the medical conditions that require support in case the tracheal wall collapses, electronic cauterization, removal of foreign body, aspiration, protection of the airway while pulling the foreign body out and controlling the foreign body whilst recovering. The wider lumen size of the rigid bronchoscope allows for the performance of the above mentioned medical procedures thereby increasing their favorability for the same. On the other hand rigid bronchoscopes are more prone to cause tissue damage and irritability and are susceptible to side effects like pneumothorax, damaged vocal cord system and others.
Flexible fibreoptic and video chip bronchoscopes have smaller lumen size and are often longer than their rigid counterparts, however due to their flexibility they can easily reach deep alveoli sacs and in some designs can perform sample biopsy, suctioning, cauterization, laser resection of tumors, etc. Cost wise, rigid bronchoscopes are much effective in comparison to flexible versions, however the latter provide better efficiency in terms of versatility and applicability. Flexible bronchoscopes being a costlier alternative are yet in great use due to this major reason.
At present the market for bronchoscopes is largest in the North American, European and Asia-Pacific region because these regions together form the most populated yet urbanized region in the world that use medically advanced form of bronchoscopes. Rigid bronchoscopes are used in low income hospitals and regions that cannot afford advanced flexible fiber optic bronchoscopes. North American region leads the global market at present and is expected to maintain its position in the near future, followed by European region. A majority of the manufacturers however are Asian origin and provide a wide range of products in the hand-held or non-electric segment. Western manufacturers are more into electric crushers and automated pulverizers.
Some of the bronchoscope manufacturers include: Olympus Corporation, Bryan Corporation, BlueMed Scientific Pvt Ltd., Uptake Medical, Pentax Medical, etc to name a few.
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