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Fiberoptic and Videoendoscope

There is no need to compare the flexible fiberoptic bronchoscope with the rigid bronchoscope. Unfortunately, since the introduction of the fiberoptic scope, the rigid bronchoscope has been used less and less.

In fact, many young endoscopists have only limited experience with it. Training in the use of the rigid open tube system has been all too often neglected.

This state of affairs might give many the impression that the fiberoptic bronchoscope has rendered the open tube obsolete. Nothing could be farther from the truth.

The open tube is the instrument of choice for most laser resection procedures. Its working channel provides optimal visualization of the airway while lasering and suctioning.

This is a great advantage particularly in case of flooding of the airways by blood, secretions and/or pus.

Though unusual, massive hemorrhage can also occur during diagnostic bronchoscopy. Therefore, we believe that even diagnostic endoscopists should know how to use a rigid open tube, and have one available in order to handle this potential complication.

Furthermore, the rigid bronchoscope is quite helpful in mechanical debridement of airway tumors and allows for measurements to be made of the airway when planning an intervention.

Finally, the quality of the image through the rigid telescope is far superior to the image obtained from a fiberoptic bronchoscope.

Fiberoptic bronchoscopes became commercially available in the late sixties. They have since greatly extended the range of visibility. Their use is now widespread, almost exclusively so.

Since the appearance of the first models, technical improvements and refinements have been incorporated constantly. In particular, the quality of the images has improved dramatically. In addition, the working channel diameter has grown significantly and the instruments have become watertight.

The videobronchoscopes provide even better images, while allowing the entire team to view and record the procedure.

All devices have working channels large enough to accept the laser fiber.

Fiberoptic bronchoscopes with 3mm working channels are currently available. However, the image quality is poor making them unsuitable for therapeutic endoscopy.

Dual working channel fiberoptic bronchoscopes are also unsuitable for similar reasons. In addition, the diameter of the second channel is too small. It is always ideal to have several fiberoptic bronchoscopes of varying diameters in stock.

Thin bronchoscopes while unsuitable for laser resection, are helpful in exploring the bronchial tree, while larger caliber fiberoptic bronchoscopes can be inserted through the working channel of the rigid bronchoscope in order to facilitate aspiration and exploration of distal airways.

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