About Interventional Pulmonology

Interventional Pulmonology is a relatively new and emerging field in respiratory or pulmonary medicine. It has developed with the goal of diagnosing and treating the conditions/diseases of the lungs and chest without operation or cutting. It achieves this by using endoscopy techniques and tools which are passed through the mouth to avoid the need for operation or incision on the chest.
It is offered by respiratory physicians (lung specialists) who have undergone extra training.

Interventional Pulmonology Techniques for Treating Lung Conditions

  • Airway re-canalization (re-opening the blocked windpipe), achieved via excision, laser, or argon plasma coagulation (APC)
  • Balloon bronchoscopy, which dilates narrowed airways via a balloon passed through a bronchoscope
  • Airway stent placement, including silicone, metal, or hybrid (silicone-covered metal) stents
  • Airway stent removal after shrinkage of cancer from cancer treatment
  • Endobronchial valve placement to correct persistent air leak in patients with pneumothorax
  • Indwelling pleural catheter to manage pleural effusion-- fluid accumulation around the lungs
  • Pleurodesis to prevent fluid around the lungs from coming back (re-accumulation)

Interventional Pulmonology Techniques for Diagnosing Lung Conditions

  • Endobronchial ultrasound (EBUS) to biopsy the enlarged lymph nodes in the centre (mediastinum) of the chest to identify if it is caused by cancer, TB or other diseases
  • Flexible bronchoscopy to biopsy the white spots (lung nodule or mass) in the lungs to identify if it is cancerous or not
  • Rigid bronchoscopy better controls the airway and larger lumen during complex endobronchial interventions; also used for mechanical tumour debulking and silicone stent placement.
  • Electromagnetic navigation bronchoscopy uses a GPS-like system to “drive” to the precise location of otherwise-inaccessible lung lesions for diagnosis and treatment planning.
  • Pleuroscopy uses an endoscope inserted into the chest cavity for diagnosis and management of pleural disease.

Conditions That Are Treated Using Interventional Pulmonology

  • White spots (lung nodule or mass) in the lungs.
  • Enlarged lymph nodes in the centre (mediastinum) of the chest.
  • Blocked windpipes (airways) from cancer or TB to open them up by laser or stenting to relieve difficulty in breathing. These treatments also offer a more rapid result, opening the airway immediately, without the delays of waiting for chemotherapy or radiation to shrink tumors. These treatments also offer an approach for patients who cannot undergo surgery because they are frail, have multiple co morbidities, or are at the end of life.
  • Fluid collection outside the lung or within the lining of the lungs.
  • Tracheoesophageal or broncho-pleural fistulas
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