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The Bronchoscopic Laboratory has as main tool the bronchoscope (rigid, flexible, ultrasound), which increases the diagnostic yield and provides therapeutic choices without surgery, while the patient is treated usually at the one day clinic facilities.
Endoscopy, in general, has a great potential and a key role in the management of a variety of pathological situations, which are already signified by other specialties like gastroenterology .
In the last decade, respiratory endoscopes (bronchoscopes) have undergone an impressive progress, which reinforced the distinct role of interventional pulmonology, specially as far as thoracic oncology is concerned. Thus, interventional pulmonology is placed on top of respiratory expertise, regarding the following diseases:
- LUNG CANCER (airway reopening and stent implementation, hemostasis, mediastinal staging by the well-known EBUS giving the right therapeutic decision for every patient.
- DIFFUSE PARENCHYMAL LUNG DISEASES (cryoprobe biopsies)
- OBSTRUCTIVE PULMONARY DISEASES (Chronic Obstructive Pulmonary Disease-Emphysema Valves implementation)
- FOREIGN BODY ASPIRATION
- PULMONARY HEMORRHAGE
Patients with a compromised respiratory system, who experience breathlessness, hemoptysis and other alarming symptoms are now able to define the root of their problem when treated by an intervetional pulmonologist or when they are referred to one by other clinicians (general practitioners, internists, pulmonologists, oncologists or even thoracic surgeons)
The standard personnel of the interventional suite is the Interventional Pulmonologist, the Anesthetist who gives sedation and two special-trained nurses. A cytologist and a cytologist-assistant are added in this team, contributing greatly in the evaluation of the EBUS-TBNA (endobronchial ultra sound – trans bronchial needle aspiration) speciment, right after the collection, with ROSE (rapid on site evaluation), providing a strong possibility of diagnosis at the end of the procedure. The mean time of an interventional procedure is 45 minutes and the patient is usually allowed to leave the hospital after some hours.
The following procedures take part in our interventional suite:
- BLVR (bronchoscopic lung volume reduction) for emphysema – Emphysema Valves
- Valve placement for postlobectomy air leak
- EBUS-TBNA puncturing lymph nodes under ultra sound guidance; gold standard for lung cancer staging.
- EBUS-mini probe for scanning peripheral lesions of the lungs
- argon plasma coagulation-electrocautery for reopening of the obstructed central airway and haemostasis
- stenting of the airways
- foreign body removal
Of course, all of the procedures of simple bronchoscopy take place in our bronchoscopic suite, for instance, biopsies both transbronchial and endobronchial, washing, AF (autofluorescence)- NBI (narrow band imaging) and BAL (bronchoalveolar lavage).
Pulmonary Empysema Valves
The first pulmonary emphysema valves placement in Greece was performed at HYGEIA Hospital, Bronchoscopy Lab, which is the only active nowadays on this field. PulmonX, the most notable company that provides valves worldwide, supplies our department exclusively in Greece. Most importantly, in October 2017, a big private insurance company approved the valves for an emphysema patient.
We are most satisfied with the latter outcome and we hope to contribute greatly towards the direction of this innovative COPD treatment, being supported by insurance companies, pulmonologists and patients .
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