Interventional Pulmonology/Bronchoscopy Unit at King’s
Pulmonology specializes in diagnosing and treating diseases of the lungs and parts of the respiratory system. Within the field of pulmonary medicine, there is a subspecialty known as Interventional Pulmonology, which is fairly new.
Interventional pulmonology involves the use of endoscopy and other advanced minimally invasive tools for diagnosing, treating, and managing conditions of the chest and lungs.
The Interventional Pulmonary Clinic at Kings is led by a team of experienced UK trained pulmonary specialists and US and European trained cardiothoracic surgeons who offer a wide range of treatments for patients suffering from respiratory conditions such as Asthma, Chronic Obstructive Pulmonary Disease (COPD), Bronchitis, Chronic Coughing and Sleep Apnea, and diseases of the lungs.
At the Interventional Pulmonary Clinic, we provide patients with the most advanced and latest minimally invasive and endoscopic procedures in state-of-the-art facilities and work closely with our doctors in other medical specialties including ENT, to ensure patients receive tailored care for their specific condition.
Interventional Pulmonary Clinic – Conditions Treated
Some of the common conditions treated at the Interventional Pulmonary Clinic in Dubai include:
- Asthma: Asthma is a chronic disease characterized by narrowing and swelling of the bronchial airways in the lungs making it difficult for an individual to breathe smoothly. Major symptoms include coughing, wheezing, tightness in the chest, shortness of breath, and rapid breathing. An asthma attack can be caused by mold, pets, dust, exercise, cold air, stress, and many other triggers.
- Tuberculosis: Tuberculosis is a disease caused by a specific type of bacteria that is normally spread from one person to another through the air. Even though tuberculosis can affect most parts of the body, it most often affects the lungs. Symptoms for tuberculosis might not manifest for years but may appear when an individual becomes ill with a serious condition like diabetes, and cancer. Tuberculosis can be treated with antibiotics.
- Pneumonia: Pneumonia is a disease characterized by severe inflammation of the lungs in which the alveoli are filled with fluid. This may lead to a decrease in the amount of oxygen that blood can absorb from air breathed into the lungs. Pneumonia is usually caused by infection, however, other causes may include radiation therapy, allergy, and irritation of the lung tissue by inhaled substances.
- Emphysema: This is a disorder that affects the alveoli of the lungs. Since the transfer of oxygen and carbon dioxide in the lungs takes place in the walls of the alveoli, the complication happens when in the emphysema, the alveoli become abnormally inflated, damaging their walls and making it harder to breathe. Smokers and people with chronic bronchitis are at a greater risk of emphysema.
- Cystic fibrosis: Cystic fibrosis is a hereditary disease in which secretory glands produce abnormally thick mucus. The mucus cause problems in breathing, digestion, and body cooling.
- Chronic Obstructive Pulmonary Disease (COPD): These are lung diseases characterized by permanent damage to the tissues in the lungs making it difficult to breathe. Common COPD conditions include chronic bronchitis, in which the bronchi get inflamed and scarred, and emphysema, in which the alveoli are damaged. COPD develops over many years and is in most cases caused by smoking.
- Respiratory Distress Syndrome: Also known as hyaline membrane disease, Respiratory Distress Syndrome occurs almost exclusively in premature infants. It is a common breathing disorder affecting nearly all newborns who are born before 28 weeks of pregnancy.
- Persistent cough: A persistent cough is described as one that persists for eight weeks or longer. The cough may manifest in two different ways; it may be dry or productive. By productive, it means that an individual may or may not cough up mucus. Different terms are used to refer to persistent cough including ‘lingering’, ‘chronic’, or ‘nagging’ cough.
- Bronchitis: This is a condition that causes irritation and inflammation of the bronchial tubes’ lining. These bronchial tubes carry air in and out of the lungs. Bronchitis can be caused by bacteria, viruses, and irritants, and can be either chronic or acute. Symptoms include coughing, wheezing, chest discomfort, sputum, shortness of breath and fatigue.
- Sleep apnea: Sleep apnea is considered a serious sleep disorder whereby breathing stops and starts again while the individual is sleeping. Obstructive sleep apnea (OSA) is the most common type of sleep apnea.
- Lung conditions: These includes lung cancer diagnosis and treatment, lung transplant, and emphysema.
- Benign airway tumors
Interventional Pulmonary Procedures
Interventional pulmonary procedures are performed by pulmonologists and cardiothoracic surgeons who have undergone extra and extensive training.
Some of the interventional pulmonary procedures include:
Bronchoscopy: This is a minimally invasive procedure in which a doctor uses a flexible endoscope (bronchoscope) to directly visualize airways. The bronchoscope is advanced through the airway in each lung to check for any possible problems. This technique can help in diagnosing different types of pneumonia, tuberculosis, and lung cancer. It also allows for specimens to be obtained if necessary, through a procedure known as biopsy.
Endobronchial Ultrasound (EBUS) with ROSE: This is a method whereby abnormal lesions in the chest can be sampled without an invasive surgical procedure. A special bronchoscope with an ultrasound attachment at the tip is used to perform biopsies in multiple chest areas but with greater accuracy. The risk of puncturing a blood vessel is also minimized as the pulmonologist/cardiothoracic surgeon can see where the needle is being placed. This procedure is used to biopsy peripheral lung lesions and lymph nodes in the middle of the chest.
Radial EBUS: This is a procedure used to identify small lesions in the lungs that cannot be reached by the bronchoscope. It uses ultrasound to identify the lesion and then certain instruments such as needles and biopsy forceps are passed through the bronchoscope to the target areas.
Bronchial stent: The airway tube (bronchus) can become constricted or blocked due to advanced cancer or other conditions, leading to coughing, difficulty breathing, and even pneumonia. A doctor can deploy a wire mesh stent into a narrowed airway using a bronchoscope. By expanding the stent, the bronchus is opened, and the symptoms caused by constriction are relieved.
Bronchoscopic thermoplasty: This is used among patients who suffer from severe asthma that cannot be controlled conservatively with medication. During the procedure, a heat probe is applied to the walls of the airways thus destroying the smooth muscle layers that have been constricted and contribute to the asthma symptoms.
Foreign body removal: Bronchoscopy is often preferred for the removal of inhaled foreign objects lodged in the airway.
Thoracentesis: During this procedure, a doctor inserts a needle into the chest wall to drain fluid that has built up around the lungs (pleural effusions). A plastic catheter is deployed over the needle and the needle is then removed. The excess fluid is suctioned from the chest using this catheter.
Pleuroscopy: This is a procedure that involves cutting small incisions in the chest wall and deploying a pleuroscope into the chest cavity. It is used to diagnose conditions in the lining of the lung (pleura). It also allows for viewing of the outside edges of the lungs, which a bronchoscopy cannot do.
Pleurodesis: This is a procedure that is performed on individuals with recurring pleural effusions (fluid around the lungs). It involves making an incision in the chest wall and inserting a plastic tube into the chest cavity, then spraying an irritating chemical around the lung. This results in the inflamed lung lining adhering tightly to the chest wall over time thus preventing fluid from reaccumulating around the lung.
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