This is a new function of the BF-290 bronchoscope series (Fig. 13.1c). A dial at the working channel insertion port allows clockwise or counterclockwise rotation of 120° (Fig. 13.1d). The rotation mechanism is also useful for fine control of the direction of the scope during selection of the involved bronchi. Most of the scopes in this series (e.g., BF-H290, BF-Q290, BF-P290, and BF-XP290) may be flexed up to 210° to enable easier operability compared with conventional scopes; an exception is BF-1TQ290, which may be flexed only up to 180°. Another advantage of this rotation function is for bronchial occlusion by EWS; this procedure entails alignment of the longitudinal axes of the target bronchus and the EWS, which may be difficult at times. In such cases, the rotation function of this new scope may address this limitation.

Among the BF-290 series, BF-H290 is the first model equipped with a high-definition screen. The quality of white light and narrow band imaging has been improved (Fig. 13.2). Compared with the traditional video endoscopy system (EVIS LUCERA SPECTRUM; Olympus Ltd), the new video system (EVIS LUCERA ELITE; Olympus Ltd) of the BF-290 series has improved sensor for noise suppression and rendering high-resolution images; in addition, the amount of light during autofluorescence imaging using BF-260F was also improved. These developments are expected to facilitate better and easier confirmation of the progression of abnormalities in the bronchial mucosa (Fig. 13.3). In particular, the quality and size of the endoscopic images of BF-P290 and BF-XP290 have improved. The conventional thin scopes of the hybrid type used to be inferior in terms of display quality and size, but these have been remarkably improved after introduction of the videoscope (Fig. 13.4). Overall, these advancements on the bronchoscope enable easier operability, especially in the peripheral lung areas.