The flexible bronchoscope has undergone many technological advances since it was first introduced more than 40 years ago [1]. But, despite these advances in imaging and ease of use, it remains a fragile piece of equipment and susceptible to damage [2]. If improvements can be made to the quality of the image and the size of the working channel without compromising the overall diameter of the instrument, why can't significant improvements be made to the durability of the bronchoscope? Very simply put, there is so much technology stuffed into such a small compartment that even slight trauma to the instrument can be devastating.

It is truly remarkable that this equipment can perform all the functions that it does when you consider the difficulties in engineering such a small diameter instrument. Let's consider the challenges we must overcome in developing the flexible bronchoscopes that are available today.

CHALLENGES AND BASIC REQUIREMENTS OF THE BRONCHOSCOPE

The bronchoscope must accomplish several feats with some challenging obstacles that it must overcome:

• It must be small enough to fit into the airway and still provide space for breathing.

• The airway does not have any illumination, so we must provide artificial light to see where we are going.

• There are bifurcations in the airway, so we need a mechanism for steering the instrument.

• The airway can be obstructed with fluid or blood, so we must have a way to clear those to continue our journey.