The interventional pulmonology centre is one of the very few advanced diagnostic and therapeutic units in the country. It encompasses services offered to a wide array of diseases, from basic bronchosopic procedures, complex airway procedures to help patients with airway obstruction breathe better to pleural procedures for diagnosing the type of pleural fluid outside the lung.
Diagnostic Bronchosopy
Which primarily involves sampling of the lung as a day care procedure with minimal sedation for patient comfort. In diseases like pneumonia or tuberculosis it necessitates the use of a respiratory endoscope(bronchoscope) to look into your lung and navigate to the affected lung through the airways and sample the lung by washing it-bronhcoalveolar lavage or by biopsying it under guidance which is called an endobronchial or transbronchial lung biopsy.
The above procedure is used for pneumonia, lung abscess, in patients with immunosuppression like post-transplant or those on chemotherapy for various reasons and even to diagnose cancer.
We are equipped with a special probe called cryoprobe which helps us sample diffuse scarring lung diseases called pulmonary fibrosis of the lung and ascertain the type of this disease. It also helps us navigate to very distant locations in the lung to pick up and biopsy small lung nodules in the lung thereby helping early diagnosis of lung cancer.
Endobronchial ultrasound(EBUS)
EBUS is an advanced bronchoscope with a special ultrasound at its tip which helps us diagnose lymph gland swelling in the middle of the chest adjoining the airways which in earlier days were accessible only by surgery. These glands can be enlarged in a wide variety of conditions like tuberculosis, sarcoidosis and lung cancer. The convex EBUS also helps to access some mediastinal structures apart from lymph nodes for sampling.
Another advanced technology called Radial EBUS(R-EBUS) which we use commonly to diagnose lesions within the lung which can help us catch early lung cancer. All these are supplemented by excellent navigation systems like CT mapping and fluoroscopy which helps us biopsy these lesions in real time.
Therapeutic bronchoscopy
There is a significant role for minimally invasive airway procedures in the airway and the lungs for offering the patients a curative treatment and better quality of life. This encompasses procedures which help with
These procedures are usually done under general anaesthesia through a special scope called rigid bronchoscope with gives access to a variety of tools.
- Recanalizing central airway obstruction with various tools
- Stent deployment to give stability to occluded airways
- Using airway sealants, glues and spigots for air leaks
- Removing smaller airway tumours and infective masses
- Providing a safe conduit when there is an abnormal communication between trachea and oesophagus.
Pleural Procedures
The thoracic videoscope helps us enter and visualize your lung cavity with minimal sedation and anaesthesia-a key hole procedure to diagnosed pleural fluids which can be because of infections like bacterial or TB, malignancy or a spate of other causes. It also helps us biopsy the pleura for a confirmatory diagnosis.
The thoracosocope can be used to perform pleurodesis in patients with recurring fluid effusion in diseases where despite treating the underlying cause the fluid accumulates.
Pleural procedures also encompass pleural fluid removal-pleural aspiration with a syringe or through special tubes like intercostal drain or pigtail catheter. The similar tubes can also be used to evacuate pneumothorax.
One of the few centres having expertise in inserting a indwelling pleural catheter for patients with recurrent pleural effusions.
