【Bronchoscopy】What lung diseases can it diagnose? Cost comparison and purpose of the examination!

Q: Is general anesthesia required for a bronchoscopy examination?

Doctors often use mild sedation medicatio n. In some cases where the bronchoscopy is expected to be more complex or longer in duration, the doctor may opt for deeper sedation or even general anesthesia.

A bronchoscopy examination is a basic diagnostic procedure for the respiratory system. It involves using a thin and flexible endoscope inserted through the mouth or nose into the trachea and bronchial branches to observe and examine the patient’s lungs. Doctors can also use the endoscope to examine the lungs and airways. The patient does not require general anesthesia for the procedure but is typically given sedation anesthesia (medication that induces sleepiness and relaxation).

If you experience the following symptoms, it is advisable to consult a doctor and arrange for a referral to undergo a bronchoscopy examination:

Chronic cough
Coughing up blood
Abnormal shadows on chest X-ray or computed tomography (CT) scan
Aspiration pneumonia (inhalation of foreign material)
Need for removal of foreign objects or obstructive secretions in the trachea
Lack of improvement in respiratory conditions or other respiratory problems despite medication

The primary purpose of this examination is to diagnose the following health issues:

Lung diseases
Respiratory system infections or tumors
Pneumothorax (collapsed lung)
Causes of coughing up blood
Lung cancer
Other unidentified lung abnormalities

Additionally, bronchoscopy can be used to clear obstructive mucus and foreign bodies from the airways.

Is bronchoscopy a reliable method for diagnosing lung cancer?

Bronchoscopy is recommended as the diagnostic method for all suspected lung cancer patients. Its sensitivity for central airway lesions is around 88%, and the overall sensitivity for diagnosing peripheral diseases using all available methods is approximately 78%.

*Sensitivity refers to the ability of the test to correctly identify patients with the condition.

Based on the published fee references from major private hospitals in Hong Kong, the cost of bronchoscopy examination with or without tissue biopsy mainly depends on whether it is performed as a day procedure or requires hospitalization. The fees range from around HK$24,000 to the most expensive at approximately HK$54,000.

Private Hospital	Day Procedure	Hospitalization
Saint Teresa’s Hospital	$24,803	$37,205
St. Paul’s Hospital	$31,065	$51,261
Hong Kong Baptist Hospital	$24,450	$46,330
Union Hospital	–	$35,390
Gleneagles Hospital Hong Kong	$39,730	$43,956
Hong Kong Sanatorium & Hospital	$54,456	$54,456
Hong Kong Adventist Hospital – Tsuen Wan	$50,314	$50,314
Hong Kong Adventist Hospital	$28,141	$52,768

NoteThe above fee information was collected from the official websites of the respective hospitals on June 28, 2022, and is for reference purposes only.

All voluntary health insurance plans provide coverage for “bronchoscopy examination with or without biopsy.” According to the surgical schedule, this examination is classified as a minor procedure. Even the Bowtie VHIS Flexi Regular Plan provides coverage up to HK$6,000, while the plus plan offers coverage up to HK$9,000.

The Bowtie Pink VHIS Plan offers a deductible ranging from HK$0 to HK$80,000. Qualified items beyond the deductible, including bronchoscopy examination, are eligible for 100% reimbursement. The monthly premium can be as low as HK$257*. You can request a detailed quote for yourself or your family without the need to log in or create an account.

*Based on a 30-year-old individual, Bowtie Pink (Semi-Private Room) with a deductible option of HK$80,000 and a monthly premium of HK$257

Bowtie provides a premium calculator that allows you to estimate monthly expenses for VHIS plans based on factors such as age, gender, and smoking habits:

Bowtie VHIS (Standard/Flexi) Calculator

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According to the examination instructions provided by Hong Kong Baptist Hospital, the entire process takes approximately 15 to 30 minutes and can be divided into four main parts:

Topical anesthesia is sprayed into the nasal cavity and throat.
Depending on the individual’s condition, the doctor may administer an appropriate amount of sedative to reduce coughing and discomfort during the examination.
The lubricated fiberoptic bronchoscope is inserted through the mouth or nose into the trachea. Local anesthesia may also be administered as needed
Visualization and sample extraction

According to the surgical information provided by Union Hospital, there are some notable points to be aware of before and after a bronchoscopy examination:

Before the examination:

Avoid eating and drinking for 6 hours before the procedure.
Empty the bladder before the surgery.

After the examination:

Avoid eating and drinking for 2 hours to prevent choking.
Dizziness may be experienced after anesthesia, so it is advisable to rest in bed for several hours after the procedure.
Notify medical staff immediately if there is pain or shortness of breath.
Patients who have tissue samples taken may need to undergo a chest X-ray.
Patients are usually discharged on the same day or the following day, but high-risk patients may require further observation and hospitalization.

Is undergoing a bronchoscopy examination very uncomfortable?

Due to the administration of sedative medication by the doctor before the procedure, patients rarely experience pain during the examination.

Is general anesthesia required for a bronchoscopy examination?

Doctors often use mild sedation medication. In some cases where the bronchoscopy is expected to be more complex or longer in duration, the doctor may opt for deeper sedation or even general anesthesia.

What are the side effects/risks of undergoing a bronchoscopy examination?

All procedures carry some degree of risk. In the period following the bronchoscopy, patients may experience mild coughing, throat discomfort, hoarseness, or blood-tinged phlegm. Doctors can prescribe medication to alleviate these symptoms. Other serious complications include irregular heartbeat, pneumothorax, respiratory tract infection, and bronchospasm.