Bronchoscopy in Hyderabad: Flexible Bronchoscopy, BAL and Lung Biopsy
Bronchoscopy is a day-care procedure in which a thin, flexible tube with a camera is passed through the nose or mouth into the windpipe and lungs, to look inside the airways and take samples. It’s used to find the cause of a persistent shadow on an X-ray or CT, a pneumonia that won’t clear, coughing up blood, or suspected TB or lung cancer. In Hyderabad, Dr. Kishan Srikanth Juvva performs bronchoscopy at Apollo Hospitals, Financial District.
| Type | Day-care procedure; no incision |
| Where | Apollo Hospitals, Financial District, Nanakramguda |
| Sedation | Throat spray plus light sedation |
| Time | 15–30 minutes for the procedure; about half a day at hospital in total |
| Fasting | About 6 hours for food |
| Going home | Same day, with an adult escort; no driving for 24 hours |
| Samples | Lavage (BAL), biopsy, brushings, as needed |
| Results | Rapid TB test in days; pathology in days; cultures up to 6–8 weeks |
| Cost | on request onwards |
| Consultations | Apollo FD (Mon–Sat 9–5) · Breathe Well, Kondapur (evenings) |
Most people are advised bronchoscopy after a scan raises a question that the scan itself can’t answer. Is this shadow an infection, TB, or something else? Why hasn’t this pneumonia cleared? Where is this blood coming from?
Bronchoscopy lets the doctor look directly inside the airways and collect the samples that answer those questions, without surgery.
What is bronchoscopy?
A bronchoscope is a flexible tube about as thick as a pencil, with a camera and light at its tip and a narrow channel running through it. The doctor guides it through the nose or mouth, past the vocal cords, and into the windpipe (trachea) and the branching airways (bronchi). The view appears on a screen.
Fine instruments passed through the channel can:
- Wash a small area of lung with sterile saline and collect it
- Take tiny tissue samples
- Brush cells from the airway lining
- Remove mucus
Flexible vs rigid bronchoscopy
- Flexible bronchoscopy is used for almost all diagnostic procedures. It’s done under light sedation, as a day-care procedure.
- Rigid bronchoscopy uses a straight metal tube under general anaesthesia. It’s reserved for specific treatments: removing an inhaled object (especially in children), opening an airway narrowed by a tumour or scarring, placing an airway stent, or controlling heavy bleeding.
Is bronchoscopy the same as endoscopy?
They’re related, but not the same. “Endoscopy” in everyday use usually means a scope into the food pipe and stomach, done by a gastroenterologist. Bronchoscopy goes into the windpipe and lungs, and is done by a pulmonologist. Both use a flexible camera tube, but the equipment, preparation and purpose are different.
Why is bronchoscopy done?
To diagnose:
- A shadow, mass or nodule on a chest X-ray or CT that needs a sample
- Pneumonia that doesn’t clear with treatment, or keeps coming back in the same place
- Suspected tuberculosis when sputum tests are negative, or you can’t cough up sputum
- Coughing up blood (haemoptysis): to find the source
- A collapsed part of the lung, or a wheeze heard on one side only
- Interstitial lung disease (ILD), when lung tissue or washings are needed
- Infections in people with low immunity: fungal infections, unusual bacteria
- A cough that remains unexplained after the usual tests
To treat:
- Thick mucus plugs blocking an airway, often in hospital or ICU patients
- Inhaled foreign bodies (seeds, nuts, small toys, pins)
- Narrowed airways and bleeding: in selected cases, by specialised techniques
Samples taken during bronchoscopy
| Sample | How it’s taken | What it’s tested for |
|---|---|---|
| Bronchoalveolar lavage (BAL) | A small amount of sterile saline is washed into one area of the lung and suctioned back | TB (rapid molecular test and culture), bacteria, fungi, cancer cells, cell counts in ILD |
| Bronchial wash and brushings | Washing or brushing the airway lining | Infection, cancer cells |
| Endobronchial biopsy | Small forceps take tissue from inside the airway | Tumours or abnormal tissue visible in the airway |
| Transbronchial lung biopsy | Forceps reach into the lung tissue beyond the airways | ILD, sarcoidosis, some infections and peripheral lesions |
| EBUS-TBNA | An ultrasound-guided needle samples lymph nodes outside the airway | Cancer staging, TB, sarcoidosis, lymphoma. See the |
| Cryobiopsy | A freezing probe takes larger lung tissue samples | ILD and fibrosis diagnosis. |
Bronchoscopy for TB when sputum tests are negative
TB is common in India, but sputum tests miss many cases, especially early ones, or when people can’t cough up sputum. Bronchoscopy samples can help close that gap.
In a one-year study of sputum smear-negative patients at a tertiary hospital in Belagavi, Karnataka, the rapid molecular test (Xpert MTB/RIF) on BAL fluid picked up TB in 93.5% of the patients eventually diagnosed with it. That compares with 41.9% by smear on the same samples. The study was published in the SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS in 2019. The same test also checks for rifampicin resistance.
How to prepare for bronchoscopy
You’ll receive written instructions. The usual steps:
- Consultation and scan review first. Bring all X-ray and CT images on CD, not only the reports.
- Blood tests: usually a blood count and clotting tests, sometimes an ECG.
- Blood thinners: tell the team about aspirin, clopidogrel, warfarin or any newer blood thinner. Some need stopping a few days before, especially if a biopsy is planned. Never stop them on your own.
- Diabetes medicines: may need adjusting for the fasting period.
- Fasting: nothing to eat for about 6 hours beforehand. Small sips of water may be allowed until 2 hours before .
- An adult escort. No driving, riding, or important decisions for 24 hours after sedation.
What happens during bronchoscopy?
- In the day-care unit, a small cannula is placed in your hand, and oxygen levels, heart rate and blood pressure are monitored throughout.
- Your nose and throat are numbed with a spray or gel, and light sedation is given, so you’re drowsy and relaxed.
- The bronchoscope is passed gently through the nose or mouth into the windpipe. Local anaesthetic is dripped onto the vocal cords and airways as it goes, to settle the cough reflex.
- The airways are examined and samples taken as planned.
- The procedure itself usually takes 15–30 minutes.
Most people remember little of it. For what it actually feels like, and how most people find it, read.
After bronchoscopy
- Observation: you’re observed for 1–2 hours while the sedation wears off.
- Eating: don’t eat or drink until the throat numbness has gone (usually 1–2 hours), then start with a sip of water.
- Common for a day or so:
- A sore throat
- A hoarse voice
- A cough
- A little blood-streaked sputum (after a biopsy)
- A mild temperature the same evening can happen after a lavage.
- Back to normal: most people are back to normal activities the next day.
Seek help urgently if you have:
- Increasing breathlessness
- Chest pain
- More than a few teaspoons of blood
- A high fever after the first evening
Is bronchoscopy safe?
Yes. Flexible bronchoscopy is a routine, well-established procedure, and serious complications are uncommon. Even for more complex guided bronchoscopy and EBUS, a prospective study published in Cancers in 2023 found that 2.4% of patients had a severe complication in the 30 days afterwards.
The risks your doctor will discuss include:
- Common: sore throat and cough
- After biopsies: minor bleeding
- During sedation: a temporary fall in oxygen levels
- Uncommon: fever or infection
- After transbronchial lung biopsy: rarely, an air leak around the lung (pneumothorax)
Bronchoscopy may be postponed if you’ve had a recent heart attack, your oxygen levels are very low, or blood clotting is abnormal. These are assessed beforehand.
Bronchoscopy results: what to expect and when
| Test on the sample | What it shows | Typical time |
|---|---|---|
| Rapid TB test (CBNAAT / Xpert) | TB and rifampicin resistance | days |
| Gram stain, bacterial culture | Bacterial infection and the right antibiotic | 2–5 days |
| Fungal stains and culture | Fungal infection (e.g. aspergillus) | Days to weeks |
| Cytology | Cancer cells, inflammatory cells | working days |
| Biopsy (histopathology) | Tissue diagnosis | working days |
| TB culture | Confirms TB; drug sensitivity | Up to 6–8 weeks |
Results are discussed at a follow-up consultation, at Apollo or in the evening at Breathe Well, Kondapur.
Bronchoscopy cost in Hyderabad
| Item | Approximate cost |
|---|---|
| Diagnostic flexible bronchoscopy with BAL (day-care, sedation) | on request |
| Add-on: endobronchial or transbronchial biopsy | on request |
| Lab tests: CBNAAT, cultures, cytology, histopathology | on request (depends on tests) |
| Pre-procedure blood tests | on request |
What changes the cost:
- What’s done: a BAL alone, or biopsies as well
- Lab tests: which tests the samples need
- Sedation: the type used
- Stay: day-care, or an overnight stay
- Extras: whether EBUS or cryobiopsy is added in the same session
Insurance: diagnostic bronchoscopy is often covered as a day-care procedure, subject to your policy terms. Apollo’s insurance desk confirms cashless eligibility beforehand.
Who performs bronchoscopy?
Bronchoscopy at Apollo Hospitals, Financial District is performed by Dr. Kishan Srikanth Juvva .
- Training:
- DM in Pulmonary and Critical Care Medicine
- Master’s in Interventional Pulmonology from the University of Florence, Italy
- Memberships:
- Indian Association for Bronchology (life member)
- World Association for Bronchology and Interventional Pulmonology (life member)
- Research: presented on therapeutic bronchoscopy at the AABIP conference in Chicago in 2023
Where to have bronchoscopy in Hyderabad
| Apollo Hospitals, Financial District | Breathe Well Clinic, Kondapur | |
|---|---|---|
| Bronchoscopy procedure | Yes | No |
| Consultation and scan review | Mon–Sat, 9 AM – 5 PM | Evenings (5:00–8:30 PM; Sunday, 10:00 AM–1:00 PM) |
| Results and follow-up | Yes | Yes |
| Book | +91 90598 73547 | +91 87122 23696 |
Bronchoscopy: frequently asked questions
Is bronchoscopy painful?
Most people find bronchoscopy uncomfortable rather than painful. The nose and throat are numbed, and light sedation keeps you relaxed, so many people remember very little. A sore throat and cough for a day are common afterwards. For a fuller answer, read.
Will I be awake during bronchoscopy?
You’ll usually be lightly sedated: drowsy and relaxed, breathing on your own, and able to respond, but most people remember little afterwards. Some procedures, such as rigid bronchoscopy or longer interventional procedures, are done under general anaesthesia, where you’re fully asleep. Your doctor explains which applies to you.
How long does a bronchoscopy take?
The bronchoscopy itself usually takes 15–30 minutes, depending on which samples are taken. Including check-in, preparation and recovery from sedation, expect to spend about half a day at the hospital. Most people go home the same day with an adult accompanying them.
Is bronchoscopy a surgery?
No. Bronchoscopy isn’t surgery. It’s a minimally invasive day-care procedure done through the nose or mouth, with no cuts or stitches. Rigid bronchoscopy, used for certain treatments, is done under general anaesthesia in an operation theatre, but still involves no incision.
Do I need to fast before bronchoscopy?
Yes. You usually need to avoid food for about 6 hours before bronchoscopy, so the stomach is empty during sedation. Small sips of water may be allowed until about 2 hours before. Follow the written instructions from the hospital, especially for diabetes medicines and blood thinners.
Can bronchoscopy detect lung cancer?
Often, yes. Bronchoscopy can take tissue or cell samples from tumours inside or near the airways, and with EBUS, from lymph nodes in the chest. Small nodules far out in the lung may need guided bronchoscopy or a CT-guided biopsy instead.
Can bronchoscopy detect TB?
Yes. Bronchoscopy is especially useful when TB is suspected but sputum tests are negative, or no sputum can be coughed up. Lavage fluid is tested with a rapid molecular TB test and culture. An Indian study found the rapid test on lavage fluid detected 93.5% of confirmed TB cases.
Is bronchoscopy safe?
Yes. Bronchoscopy is a routine and safe procedure. Serious complications are uncommon. A sore throat, cough and slight blood in the sputum after a biopsy are common, and settle quickly. Rare risks include bleeding, low oxygen during sedation, infection and, after some biopsies, an air leak around the lung.
Do I need to stay in hospital after bronchoscopy?
Usually not. Most people go home the same day after 1–2 hours of observation. An overnight stay is occasionally advised after certain biopsies, if oxygen levels stay low, or for patients with significant heart or lung disease. You must have an adult to take you home.
How much does bronchoscopy cost in Hyderabad?
At Apollo Hospitals, Financial District, a diagnostic bronchoscopy with lavage is priced on request, with biopsies and lab tests charged according to what’s needed . The total depends on the samples taken, the tests ordered and the type of sedation. Many insurance policies cover it as a day-care procedure.
Sources
- University Hospitals Sussex NHS Foundation Trust. Bronchoscopy: patient information, December 2025 (fasting, sedation, duration, recovery, driving)
- Thirty-day complications, unplanned hospital encounters, and mortality after endosonography and/or guided bronchoscopy: a prospective study, Cancers, September 2023 (2.4% severe complications at 30 days)
- Gaude GS, Samskruti S, Hattiholi J, Patil B. Diagnostic yield of bronchoalveolar lavage Xpert MTB/RIF assay in sputum smear negative pulmonary tuberculosis patients, SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS 17(2): 1–7, 2019 (BAL Xpert positive in 93.5% vs smear 41.9%). Note: this is the most relevant Indian data found, but it’s from 2019. Replace it if Dr. Kishan has a more recent Indian reference.
- National Medical Commission advertising guidelines (6 Oct 2026), as summarised by HMS Consultants (factual fees permitted; no case publicity)
Medically reviewed by Dr. Kishan Srikanth Juvva, MBBS, MD, DM (Pulmonary & Critical Care Medicine), Master’s in Interventional Pulmonology (University of Florence). Senior Consultant, Apollo Hospitals, Financial District. Reg. No.. This page is general information and doesn’t replace a consultation.