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The Latest Generation in Flexible Bronchoscopes: A Description and Evaluation

Hsia, David W. MD*; Tanner, Nichole T. MD; Shamblin, Clayton MD; Mehta, Hiren J. MD; Silvestri, Gerard A. MD; Musani, Ali I. MD

Journal of Bronchology & Interventional Pulmonology: October 2013 - Volume 20 - Issue 4 - p 357–362
doi: 10.1097/LBR.0000000000000014
Tools of the Trade

Background: Since the introduction of the flexible bronchoscope over 50 years ago, bronchoscopists have seen vast improvement in the technology available for diagnostics and therapeutics in the bronchoscopy laboratory. We set forth to evaluate the latest evolution in flexible bronchoscopes with features designed to improve imaging and airway navigation.

Methods: The BF-Q190, BF-H190, and/or BF-1TH190 bronchoscopes were evaluated prospectively in 105 patients undergoing bronchoscopy from November 2010 to August 2011 at 2 tertiary care centers in the United States. Data collected from each procedure included method of insertion, airway images, and therapeutic interventions. At the completion of the study, 10 bronchoscopists were surveyed using a 7-point Likert scale to identify the perceived benefits of the design.

Results: Insertion methods included nasal, oral, laryngeal mask airway or endotracheal tube, and tracheostomy. Procedures performed included bronchoalveolar lavage, endobronchial biopsy or brushing, transbronchial biopsy, transbronchial needle aspiration or injection, peripheral navigation, and large airway therapeutic interventions. Survey of bronchoscopists revealed that when compared with current bronchoscopes, the features rated as having the most significant impact on functionality are the 210-degree tip angulation (average 2.4/3) and rotational capability of the insertion tube (average 2.4/3).

Conclusions: The new-generation flexible bronchoscope offers improvement in image quality, magnification options, unique insertion tube rotation, and an increased 210-degree distal tip angulation over currently available flexible bronchoscopes. The bronchoscopes are an overall improvement to the current generation of bronchoscopes. The increased tip angulation and novel rotating insertion tube add the most to improvement in functionality.

*Harbor-UCLA Medical Center, Torrance, CA

Medical University of South Carolina, Charleston, SC

National Jewish Health, Denver, CO

Disclosure: G.A.S. has received an unrestricted research grant from Olympus corporation and consultant fees of <$10,000 which were unrelated to this product. A.I.M. has received consultancy fee and unrestricted grant for teaching courses at NJH. The remaining authors declare that there is no conflict of interest or other disclosures.

Reprints: David W. Hsia, MD, Harbor-UCLA Medical Center, 1000 W. Carson Street, P.O. Box #405, Torrance, CA 90509 (e-mail:

Received February 21, 2013

Accepted August 26, 2013

© 2013 by Lippincott Williams & Wilkins.