Interventional pulmonology (IP) is a subspecialty of pulmonary medicine focused on the use of minimally invasive procedures for diagnosis and treatment of both malignant and non-malignant diseases of the airways, lungs, chest lymph nodes and pleura.
Conditions we treat include:
Northside Hospital’s commitment to excellence is apparent through investment in the latest technology and skilled providers. We offer cutting-edge diagnostic and therapeutic procedures, including robotic bronchoscopy, photodynamic therapy and endobronchial valves. The Interventional Pulmonology Program has grown to meet the demands of our healthcare system, offering patients the service they need closer to home.
Many IP procedures support, or in many cases replace, more traditional invasive surgical procedures for diagnosis and treatment of lung diseases. Minimally invasive procedures result in less trauma, faster recovery, and reduced risk of complications.
Electromagnetic Navigation Bronchoscopy (ENB) – The electromagnetic navigation system uses trackable instruments with embedded sensors that are guided to the lung lesion using GPS technology. Standard CT images of the lung create a “route” to the lesion, allowing physicians to easily biopsy and place markers for planned treatment. As a result, physicians can navigate to and biopsy lesions located deep in the lungs using a minimally invasive approach.
Endobronchial Ultrasound Bronchoscopy (EBUS) – EBUS allows physicians to perform a technique known as transbronchial needle aspiration (TBNA) to obtain tissue or fluid samples from the lungs and surrounding lymph nodes without conventional surgery. The samples can be used for diagnosing and staging lung cancer, detecting infections, and identifying inflammatory diseases that affect the lungs, such as sarcoidosis or other cancers like lymphoma.
Robotic Bronchoscopy – Our cutting-edge robotic bronchoscopy platform allows for less invasive techniques to obtain biopsies through bronchoscopes while maintaining direct visualization of very small peripheral nodules. These new bronchoscopes allow specialized pulmonologists to telescope to extremely small airways which previously were too tortuous to access with a conventional bronchoscope. With the camera embedded in these telescoping catheters, direct visualization is never lost even while navigating to the smallest airways with small precise movements.
Photodynamic Therapy (PDT) – PDT is a bronchoscopy procedure that uses light-activated medicines and a laser to destroy cancer cells and treat symptomatic tissues. Unlike radiation and chemotherapy, PDT can be repeated on the same area multiple times, making it a good option for treating tumors that may reoccur. PDT is an outpatient procedure that takes just a few minutes to perform.
Endobronchial Valves – Endobronchial valve placement is a treatment option for those patients who have severe emphysema. Placed in targeted areas of the lungs during a minimally invasive bronchoscopic procedure, endobronchial valves can improve breathing by redirecting air from diseased parts of the lung to healthier parts. This may help reduce hyperinflation and improve overall lung function and quality of life for those patients living with emphysema.
Stent Placement – Tracheal and bronchial stents are placed for both malignant and nonmalignant diseases of the trachea. The stent is a hollow tube made of a number of different materials that are placed into the trachea or larger airways to maintain patency and stabilize larger airways. Stents are temporary, but can be kept in place for up to six weeks as more definitive treatment for a narrowed airway is investigated.
Tunneled Pleural Catheter Placement – This is similar to chest tube placement. The biggest difference is that tunneled pleural catheters are for recurrent fluid collections related to malignancies. This catheter is stitched into place and has a small valve that allows the patient or their caregiver to drain the fluid if it re-accumulates quickly. This is a good option for those patients who require frequent drainage. It allows them to drain fluid at home at the patient's convenience.
Whole Lung Lavage for Pulmonary Alveolar Proteinosis (PAP) – One lung is inflated on a ventilator, while the other is filled with saline and then washed out. The procedure is used to remove mucus that fills the airways in PAP that patients cannot clear on their own.
Interventional pulmonology procedures are key in diagnosing, staging and treating lung cancer. These procedures are often used in combination with radiographic imaging (PET scan, CT scans, and ultrasounds) to find if a cancer has spread in the lung, lymph nodes and other structures in the chest.
In conjunction with our Northside Hospital Cancer Institute Lung Cancer Program, we work closely with thoracic surgeons, medical oncologists and radiation oncologists to quickly and accurately stage primary lung cancers as well as other cancers which have spread to the lung.
Some cancers can partially or completely block airways, causing shortness of breath or pneumonia. An interventional pulmonologist can use lasers, cryo-debridement (a liquid nitrogen freezing procedure) and medications separately or in combination to open airways and relieve the obstruction and improve symptoms of shortness of breath.