Rigid Bronchoscopy Foundations
A blended curriculum introducing rigid bronchoscopy instrumentation, core maneuvers, and team communication using simulation-forward practice.
Prerequisites
- Airway anatomy refresher module
- Credentialed moderate sedation training
Equipment
- Rigid bronchoscope set
- Simulation airway mannequin
- High-flow oxygen source
Curriculum
Facilitated slide deck reviewing equipment setup, topographical airway anatomy, and shared mental models for the procedure.
Resources
Yearlong Rigid Bronchoscopy Curriculum
Twelve-month progression blending didactics, simulation, live case application, and reflection. Expand any month to review objectives, clinical focus areas, practice labs, and assessment prompts.
Overview & Objectives
Learning Objectives
- Understand the role of rigid bronchoscopy in interventional pulmonology
- Identify clinical indications and contraindications
- Recognize and name all components of the rigid bronchoscope
- Compare rigid vs. flexible bronchoscopy applications
Introduction to Rigid Bronchoscopy
Rigid bronchoscopy (RB) is a cornerstone skill in interventional pulmonology, providing unique capabilities for managing complex airway pathology. This month introduces the fundamental concepts that will form the foundation for your year-long training.
Key Historical Context
Rigid bronchoscopy was the first bronchoscopic technique, pioneered by Gustav Killian in 1897 for foreign body removal. Despite the advent of flexible bronchoscopy, rigid bronchoscopy remains irreplaceable for certain procedures.
Clinical Focus & Decision-Making
Clinical Indications
Therapeutic Indications
- Malignant Central Airway Obstruction (CAO): Tumor debulking, laser therapy, stent placement
- Benign CAO: Post-intubation stenosis, inflammatory strictures
- Massive Hemoptysis: Superior suction capability and airway control
- Foreign Body Aspiration: Large bore allows use of various retrieval instruments
- Silicone Stent Placement: Requires rigid bronchoscope for deployment
Diagnostic Indications
- Large airway biopsies when bleeding risk is high
- Assessment before surgical resection
Important Note
Absolute contraindications are few: cervical spine instability, severe hemodynamic instability. Most contraindications are relative and must be weighed against potential benefits.
Skills Lab & Simulation
Rigid Bronchoscope Components
Equipment Assembly Demonstration Video
Main Components:
- Bronchoscope Barrel: Available in sizes 3-18mm diameter, various lengths
- Telescopes: 0°, 30°, and 90° viewing angles
- Light Source: High-intensity cold light source
- Ventilation Ports: Side ports for ventilation connection
- Working Channel: For instrument passage
Common Accessories:
- Large biopsy forceps
- Suction catheters (various sizes)
- Foreign body retrieval forceps
- Optical forceps
- Cleaning brushes
Size Selection Guidelines:
| Patient Type | Typical Size Range |
|---|---|
| Adult Male | 8.5-9.5 mm |
| Adult Female | 7.5-8.5 mm |
| Pediatric | 3-7 mm |
Assessment & Reflection
Clinical Problem Solving
Scenario: Patient with post-intubation tracheal stenosis, failed dilation x2. You place a silicone stent. Two weeks later, they return with dyspnea. Most likely cause?
A) Stent fracture B) Mucus plugging C) Tracheomalacia D) Pneumothorax
Technical Question: When deploying a Y-stent at the carina, which limb should be positioned first?
Reading & Resources
Required Reading
**Comprehensive Review:** Folch E, et al. "Airway stents" *Ann Cardiothorac Surg* 2018 **Technical Guide:** Dutau H, et al. "Silicone stents - The rigid bronchoscopy approach" *J Bronchology Interv Pulmonol* 2019 **Complications:** Oki M, Saka H. "Airway stenting for patients with malignant central airway obstruction" *Respirology* 2018
Learning outcomes
- Learner demonstrates safe insertion and removal technique with coordinated assistant communication
- Learner completes post-case debrief using the standardized team checklist
Rigid Bronchoscopy Readiness Check
Select an answer to reveal the explanation. Responses are stored locally for now; LMS sync arrives with analytics.