The Interventional Pulmonology Program at Henry Ford
Hospital is one of the few in the United States to offer the full scope of
diagnostic and therapeutic services, from the initial evaluation to
endobronchial treatment of early disease to palliative management of complicated
patients.
Henry Ford's Interventional Pulmonology team is developing and using the
newest diagnostic technologies. In addition to routine diagnostic
bronchoscopy we offer:
Autofluorescence Bronchoscopy
Endobronchial Ultrasound
Transbronchial Needle Aspiration Biopsy
Rigid and Flexible Biopsy Techniques
Percutaneous Needle Biopsy
Interventional Pulmonology treatment techniques and technologies
include:
Bronchoscopy: A minor surgical procedure where a
tube is passed through the patient's nose or mouth and throat and into the
lungs to diagnose or treat lung diseases or to remove foreign bodies from the
lungs. Typically, bronchoscopy is done as an outpatient
procedure.
Airway Stenting: Airway stents are tiny cylindrical
tubes that are inserted into the airways to hold them open. Stents can
be made of metal alloys, silicone, or hybrid stents that are a combination of
the two. The Interventional Pulmonologists at Henry Ford have extensive
experience with all varieties of airway stents for both malignant and
non-malignant airway disorders.
Argon Plasma Coagulation (APC): This is the
application of heat produced by an electric current to destroy tumor tissue or
stop bleeding using a jet of argon gas. The argon gas jet allows heat to
be applied in a non-contact method.
Balloon Dilatation: This involves the opening of
the airway using a balloon, similar to the opening of coronary arteries by
angioplasty. This is particularly useful when the airway is narrow from
things like scarring after a tracheostomy. Depending on the location of
the airway narrowing, it can either be performed using the flexible or rigid
bronchoscope.
Brachytherapy: Many patients with lung cancer are
treated with standard radiation therapy - that is, the radiation energy comes
from a large machine. While this is excellent treatment for many patients with
lung cancer, the normal tissues can only tolerate a certain amount of
radiation. In certain lung cancer patients, the cancer that narrows the airway
can be treated with radioactive seeds, which are placed for a short while into
the bronchial tubes. This can shrink the cancer and open the bronchial tubes,
making it easier to breathe. A bronchoscope is used to help insert a narrow
plastic tube into the airway and choose the proper sites for the position of
the radioactive seeds.
Cryotherapy: This involves the destruction of
airway tumors by freezing the tissue. This can be performed under rigid
or flexible bronchoscopy. The tumor tissue undergoes repeated
application of a probe that is then super-cooled to freeze the tissue, and
this is applied over the entire surface of the tumor. Cryotherapy has a
delayed affect prior to a beneficial effect being observed, whereas laser
bronchoscopy, coring of tumor, or stent placement often provides immediate
relief of airway obstruction.
Electrocautery: This is the application of heat by
direct contact to destroy tumor tissue, using an electrical current to
generate the heat. A variety of special instruments can be used through
both the flexible and rigid bronchoscope to allow for the safe destruction and
removal of tumor tissue. The amount of destruction depends on the
wattage used and the surface area of the contact point of the instrument that
the energy is being delivered through.
Foreign Body Removal: Aspirated foreign bodies can
be removed under conscious sedation with flexible bronchoscopy when
appropriate, or removal is performed in the operating room under general
anesthesia by rigid bronchoscopy.
Laser Therapy: This is the application of heat using a
laser to destroy tumor tissue. The Interventional Pulmonologists at
Henry Ford Hospital use the Nd:Yag or the KTP laser depending on the specific
needs of the individual patient. The Interventional Pulmonologists at
Henry Ford have over 20 years experience in the use of laser therapy for the
safe treatment of airway tumors as well as specific non-malignant airway
problems.
Photodynamic Therapy: Certain chemicals are known
to be concentrated in cancerous cells when they are injected into the blood
stream. If the proper laser is used, the interaction of the light energy with
the chemicals causes the cancer cells to be damaged. This interaction of light
energy with the chemicals is called photodynamic therapy, or PDT. For patients
with very early lung cancers in the bronchial tubes, this type of treatment
can be curative and prevent the need for surgery.
Whole Lung Lavage: With alveolar proteinosis, a
very rare pulmonary syndrome that can lead to severe shortness of breath, the
only type of treatment is to lavage, or wash out, the protein deposits in the
lung air spaces. Henry Ford Hospital pulmonary physicians are the only lung
specialists in the state of Michigan who perform this procedure for both lungs
at the same time. Very large amounts of fluid are needed, and one lung is
washed out first, followed a short time later by washing out the second lung.
This is done under general anesthesia with very carefully controlled
conditions, because of the large amounts of fluid, which must be used to clear
the lungs of the protein deposits.
