Bronchoscopy & Interventional Pulmonology

The section of Bronchoscopy & Interventional Pulmonology at PCCS specializes in minimally invasive procedures for the diagnosis and treatment of lung cancer, complex benign airway diseases and pleural (lining of the lungs) pathologies.

Physicians at PCCS have a close relationship with thoracic surgery, medical oncology, radiation oncology, allergy, rheumatology, ENT and internal medicine for the multi-disciplinary approach of complex thoracic diseases.

Advance diagnostic procedures

We perform all the basic bronchoscopic procedures to diagnose malignant, infectious and inflammatory disorders of the lungs.

Also, PCCS have expertise in the most advanced techniques for pulmonary diagnosis, including endobronchial ultrasound (EBUS), electromagnetic navigation (GPS-like bronchoscopy) and Confocal Endomicroscopy.

Endoscopic Procedures (for diagnosis)

  • Flexible bronchoscopy
  • Bronchoalveolar lavage
  • Bronchoscopic lung biopsy (BLBX)
  • Transbronchial needle aspiration (TBNA)
  • Bronchial brushings
  • Convex-probe Endobronchial Ultrasound (cp-EBUS)
  • Radial Endobronchial Ultrasound (r-EBUS)
  • Electromagnetic Navigational Bronchoscopy (EMN)
  • Confocal Endomicroscopy
  • Narrow band imaging

 Therapeutic bronchoscopy

PCCS / interventional pulmonology performs all the therapeutic procedures to treat tracheal or bronchial obstructions either from cancer and non-cancer diseases.       We use rigid and flexible bronchoscopes with thermal (i.e., LASER, freezing, etc) and non-thermal techniques (i.e., microdebrider) to remove tumors from the airways. When needed stents are placed to maintain airway patency.

For severe persistent asthma, bronchial thermoplasty is offered for selected patient candidates.

Other unique therapeutic procedures are the placement of fiducial markers in the lung to guide lung cancer-radiosurgery and endobronchial valves to improve airway fistulas.

Multiple techniques are used to safely and effectively remove accidentally inhaled foreign bodies.

 

Endoscopic Procedures (for treatment)

  • Rigid bronchoscopy
  • Nd:YAG laser
  • Argon Plasma Coagulation (APC)
  • Electrocautery
  • Cryotherapy
  • Stents (silicone & metallic stents)
  • Microdebrider
  • Balloon dilatation
  • Airway injection of steroids
  • Endobronchial application of Mitomycin-C
  • Endobronchial valves
  • Fiducial marker placement for radiosurgery
  • Brachytherapy
  • Bronchoscopic lung volume reduction (coils)
  • Bronchial thermoplasty
  • Transtracheal oxygen catheter placement
  • Percutaneous tracheostomy

Pleural disorders

PCCS diagnose and treat pleural effusions (fluid between the lung and the chest wall). We do thoracic ultrasound to diagnose and guide the removal of pleural fluid (thoracentesis) in our office procedure room. In fact, ultrasound-guided thoracentesis can be scheduled and performed in a timely manner at the office.

 

Pleural Procedures (for diagnosis and/or treatment)

  • Ultrasound guided thoracentesis
  • Chest tube placement
  • Tunneled pleural catheter (for cancer-related pleural fluid)

Pulmonary Diseases

Below are some of the commonly diagnosed and treated diseases in a comprehensive and multidisciplinary approach at PCCS/Interventional Pulmonology section:

  • Solitary pulmonary nodule (SPN)
  • Lung cancer
  • Benign airway obstruction/stenosis
  • Malignant central airway obstruction
  • Subglottic / tracheal stenosis (obstruction)
  • Hemoptysis (coughing-up blood)
  • Pleural effusions (benign and malignant)
  • Tracheobronchomalacia / dynamic airway collapse (floppy airway)
  • Emphysema / COPD
  • Severe and persistent asthma
  • Airway fistulas
  • Prolonged air leaks
  • Aspiration of foreign bodies
  • Malignant pleural effusions