Interventional Pulmonology
Interventional pulmonology uses minimally invasive procedures to diagnose and treat various diseases of the lungs, including lung cancer, pleural diseases and many types of complex airway and lung disorders.
Our interventional pulmonology team combines the latest technology with a collaborative, interdisciplinary approach to provide patients with alternatives to more invasive surgical procedures. Our interventional pulmonologists work alongside an expert team of primary care physicians, pulmonologists, medical oncologists, thoracic surgeons, radiation oncologists, radiologists, otolaryngologists and anesthesiologists to provide comprehensive care for complex medical pulmonary conditions.
Our team—comprised of interventional pulmonologists, a group of dedicated anesthesiologists, and experienced nursing and respiratory staff—uses a specialized procedure suite equipped with the most advanced technologies, including rigid and flexible bronchoscopy, cryobiopsy, navigational bronchoscopy, pleuroscopy, a cone-beam CT scanner and on-site cytopathology support.
Conditions treated
- Airway obstructions, including foreign bodies
- Central airway collapse (tracheobronchomalacia)
- Emphysema
- Interstitial lung disease
- Lung nodules/masses
- Mediastinal adenopathy or masses
- Pleural disease
- Pneumothorax
Tests, treatments and services offered
Flexible or rigid bronchoscopy
Flexible and rigid bronchoscopy is performed by inserting a small flexible or rigid scope—with an attached camera—into the airways. This procedure is used to diagnose and treat a wide array of diseases including airway blockages, infections and lung cancer. The patient is normally asleep during this procedure and is sedated by our anesthesiology team.
Airway tumor/tissue ablation
Ablation is a technique that destroys tissue through heating. In order to produce the heat. needles are placed into the lung, using imaging technology to help guide the physician.
Endobronchial ultrasound (EBUS)
Endobronchial ultrasound is a minimally invasive procedure using an EBUS bronchoscope, which is a flexible bronchoscope combined with an ultrasound. Using this bronchoscope, physicians can examine and biopsy suspicious lymph nodes adjacent to the airways. EBUS can help diagnose lung cancer or many inflammatory and infectious diseases without performing surgery. Our patients normally go home the same day as the procedure.
Electromagnetic navigational bronchoscopy (ENB)
Electromagnetic navigational bronchoscopy is a minimally invasive procedure allowing the bronchoscopist to use GPS-like technology to create a 3D map of your airways, allowing the physician to navigate to your lung nodule and obtain tissue without surgery. This procedure can biopsy lung nodules that cannot be obtained through traditional bronchoscopy, as well as place fiducial markers and help diagnose early-stage lung cancer, allowing for rapid treatment. Patients normally go home the same day.
Endobronchial valve (EVB) placement
An endobronchial valve is a small medical device that can be implanted in an airway to treat airway leaks and to help certain patients with emphysema breath more easily. In patients with severe emphysema, EBV placement usually requires a three-day hospital stay for monitoring.
Cryobiopsy
Cryobiopsy uses a cryoprobe, or a freezing probe, to obtain lung tissue while protecting the architecture of the airways, allowing pathologists to more accurately diagnose diseases of the lung, including Interstitial lung disease. Patients normally go home the same day as the procedure.
Balloon dilation
Using the bronchoscope, physicians can insert and inflate a small balloon, improving the airway narrowing caused by tumors, inflammatory conditions or other airway diseases. This can provide immediate improvement in airway narrowing. If narrowing continues, balloon dilation can pave the way for stent placement, if necessary.
Airway stents
Tracheobronchial airway stents are small tubes that are placed into the airway to help keep them open. They can be made of silicone or metal and can be permanent or temporary.
Thoracentesis
For this procedure, the physician first uses an ultrasound to locate a pocket of fluid. Next, a small needle with a catheter (much like an IV) is inserted into the chest cavity to obtain suspicious pleural fluid. Once collected, the fluid is sent for analysis and can help diagnose cancer, infection or many inflammatory processes. Removing this fluid can also help the patient breathe more easily. Patients normally go home the same day as the procedure.
Tunneled pleural catheter placement
After thoracentesis, the pleural fluid sometimes reaccumulates and symptoms can recur. In these cases, physicians sometimes place a more permanent catheter allowing drainage at home, either by the patient themselves or a visiting nurse. This procedure can decrease hospitalizations and improve patient comfort and quality of life. The procedure itself is similar to a thoracentesis and the patient normally goes home the same day it is performed.
Pleuroscopy (Medical thoracoscopy)
Thoracoscopy is a minimally invasive procedure used to examine the chest cavity for abnormalities. A small incision is made in the chest wall and a small tube with a camera at the end is inserted. With this tool, the physician can take biopsies of abnormal-looking tissue and take fluid samples to diagnose a wide array of diseases.
Percutaneous dilation tracheostomy (PDT)
Percutaneous dilational tracheostomy is a minimally invasive procedure that inserts a small tube into the anterior neck of a critically ill patient. It is usually done at the bedside in the ICU.
To learn more about our Interventional Pulmonology Program—or to schedule an appointment or refer a patient—please call the Pulmonary Clinic at 504.988.8600.