Interventional Pulmonology

Interventional Pulmonology (IP) is a specialty within pulmonary medicine. IP uses advanced methods to diagnose and treat patients with lung cancer, pleural diseases and airway disorders.

What are the advantages of IP at the University of Tennessee Medical Center?

Interventional pulmonology services are provided on either an inpatient or outpatient basis. The outpatient clinic in Knoxville, Tennessee schedules procedure times in blocks to quickly help patients experiencing respiratory symptoms and to ensure fast results.

The University of Tennessee Medical Center is the only facility in the area with endobronchial ultrasound (EBUS) used to diagnosis lung cancer, infections and other diseases. Very small lung lesions can be sampled through techniques that eliminate the need for more invasive procedures and may increase the chance of diagnosing lung cancer at earlier stages. Complex airway problems are also handled by a team that combines interventional pulmonologists and thoracic surgeons.

The IP program in Knoxville is able to offer state-of-the-art procedures utilizing the latest technological developments in diagnosing and managing various diseases of the lungs. These procedures include the following.

Advanced diagnostic bronchoscopy

Endobronchial ultrasound (EBUS) – EBUS is a minimally invasive method of diagnosing lung cancer, infections and other inflammatory diseases. EBUS enables doctors to obtain tissue or fluid samples from the lungs and surrounding lymph nodes. EBUS also provides real-time imaging of airways, blood vessels, lungs and lymph nodes.

Rigid bronchoscopy – A bronchoscope (a long, thin tube) is inserted into an airway, usually through the nose or mouth. This test helps doctors look for abnormalities, such as foreign bodies, bleeding, tumors or inflammation, that could be blocking the airway.

Electromagnetic navigational bronchoscopy (ENB) – ENB is used to test or biopsy lesions or specimens that are too small or too difficult to reach using other, more common procedures.

Pleural disease management

Thoracentesis and pleural biopsy – This procedure removes fluid or air from the pleural space or body cavity surrounding the lungs. It is used to diagnose or treat diseases within the pleural cavity.

Chest tube with pleurodesis – A chest tube is inserted into the pleural cavity in order to perform pleurodesis. Pleurodesis is done to remove fluid surrounding the lungs and to prevent fluid from accumulating.

Tunneled pleural catheter – This is an outpatient treatment to help prevent the recurrence of fluid accumulation around the lungs.

Placement of bronchial valves for bronchopleural fistula closure – A fistula is an abnormal connection or passageway between organs or blood vessels that do not normally connect. Valves are used to close a fistula between the pleural space and the lungs to prevent air leaks.

Artificial airways

Percutaneous tracheostomy – A small incision is made in emergency situations to gain access to the trachea or windpipe.

Transtracheal oxygen catheter – Oxygen is delivered directly to the lungs through a catheter or small, flexible tube that has been placed into the windpipe or trachea.

Therapeutic bronchoscopy

Relief of central airway obstruction caused by tumor or foreign object

Tracheal or bronchial dilation and stenting – These procedures help relieve difficult breathing.

Treatment of carcinoma in situ – Early forms of carcinoma are treated before the surrounding tissue is affected.

Treatment of tracheobronchomalacia or other benign airway stenosis – Airway collapse during breathing or coughing is prevented.

Placement of catheters for brachytherapy – Catheters or small flexible tubes are placed to treat different types of cancer.

Placement of fiducial markers for CyberKnife – Fiducial markers are points of reference or landmarks that help doctors target tumors for treatment.

Whole-lung lavage for pulmonary alveolar proteinosis – One lung is placed on a ventilator while the other lung is filled with saline and drained. This procedure helps clear out any materials clogging the air spaces in the lungs.

Bronchial Thermoplasty

Bronchial Thermoplasty (BT) is a non-drug procedure that reduces severe asthma symptoms in patients 18 years or older who are not well controlled with standared asthma medications.

BT is a minimally invasive bronchoscopic procedure performed in three outpatient procedure visits, each treating a different area of the lungs and scheduled approximately three weeks apart. After all three procedures are performed, the bronchial thermoplasty treatment is complete.

Learn more about bronchial thermoplasty and its benefits here.