Interventional Pulmonology uses the latest technology to diagnose and treat a variety of lung conditions using minimally invasive techniques. Interventional pulmonologists undergo advanced training to provide these specialized services.
At Weill Cornell Medicine, interventional pulmonologists are part of a team of experts that provide comprehensive care to patients with complex chest disorders. This team includes thoracic surgeons, medical oncologists, radiation oncologists, interventional radiologists and ENT (ear-nose-throat) specialists.
• Lung Cancer Screening Program — This program provides comprehensive evaluation for patients with pulmonary nodules. We also offer lung cancer screening to appropriate patients using a low dose chest CT.
• Advanced Bronchoscopy Program — Bronchoscopy is a diagnostic tool that allows us to examine your air passages by inserting an instrument called a bronchoscope.
• Endobronchial Ultrasound (EBUS) — EBUS assists in diagnosing lung nodules and enlarged lymph nodes in the chest without surgery.
• Electromagnetic Navigational Bronchoscopy — This method uses a catheter with GPS tracking capabilities to locate difficult-to-reach lung nodules.
• Insertion of fiducial markers — These tiny gold seeds are placed in or near a tumor as a point of reference during stereotactic radiosurgery.
• Narrow Band Imaging — This technique uses light in blue and green wavelength spectrum to enhance certain aspects of airway lesions.
• Complex Airway Disease Program — We provide customized care for patients with cancer or non-cancer airway disorders. These conditions include:
• Relief of obstruction affecting the windpipe (trachea) and main bronchi
• Management of tracheostomy-related complications
• Treatment of tracheal scarring (the narrowing of windpipe)
• Evaluation and management of tracheobronchomalacia (TBM), an under-recognized condition resulting from excessive narrowing of main air passages during exhalation. TBM commonly causes chronic cough and shortness of breath that do not improve with standard treatment.
We use a variety of advanced endoscopic techniques to perform procedures that were traditionally not possible or required extensive surgery. These include:
• Rigid and flexible bronchoscopy — This procedure uses a combination of metallic and fiberoptic cameras to examine the tracheobronchial tree.
• Cryotherapy — Cryotherapy uses cold nitrous oxide gas to freeze tumors or remove foreign bodies.
• Hot therapies — Examples of this type of therapy include Argon plasma coagulation (APC) and laser. During treatment, APC or lasers are used to burn the tumor and control bleeding.
• Airway Stenting — In this procedure, surgeons insert a metallic and silicone prosthesis to open up a blocked or closed airway.
• Endobronchial brachytherapy — Using a bronchoscope, physicians deliver a high dose of internal radiation to rapidly destroy a tumor blocking the trachea or bronchi.
• Photodynamic therapy — Photodynamic therapy is a light-based therapy delivered via a bronchoscope to destroy a tumor blocking the trachea or bronchi.
Pleural Disease Service
Pleural effusions occur when fluid accumulates between the lung and the pleura, the thin membranes that line the lungs and the inside of the chest cavity.
Weill Cornell Medicine offers a variety of treatments depending on your condition, including:
• Ultrasound-Guided Thoracentesis and Chest Tube Placement — In this procedure, we use a small catheter to remove pleural fluid. An ultrasound helps physicians determine where to insert the catheter making procedure safe.
• Tunneled Pleural Catheter — This option allows patients to leave the hospital with a pleural drain, thereby allowing patients to drain fluid at comfort of their home.
• Pleuroscopy — A pleuroscopy is a direct examination of the outer layer of the lung using a small camera through a single incision which allows physicians to determine the cause of fluid buildup. Pleural biopsies are performed under direct optical control
Endobronchial Treatment of Asthma and COPD (chronic obstructive lung disease) includes:
• Bronchial Thermoplasty Program — This novel bronchoscopic procedure offers additional treatment options for patients with severe asthma not responding to medical therapy.
• Endobronchial Lung Volume Reduction — This is a new bronchoscopic treatment option for select patients with severe emphysema that has been shown to improve breathlessness. Learn more about this procedure.
We recommend visiting the Weill Cornell Medicine Cardiothoracic Department website, as well as the National Cancer Institute and the Lung Cancer Research Foundation.
Once you and your care team decide that surgery is the best treatment plan for your condition, you will schedule a pre-surgical appointment at M404.
During your pre-surgical appointment:
• Your nurse practitioner will explain what you can expect for your specific surgery and hospital stay
• Your nurse practitioner will review your current medications
• You will sign a consent form for the surgery and potential blood transfusion (Please note: Most patients do not receive blood transfusions during surgery, but we are required to have you sign this consent form, just in case you do need a transfusion and are not awake at the time to give your consent. ALL blood is stringently tested for HIV, hepatitis, and cytomegalovirus.)
• You have the opportunity to ask questions
• You will receive a small bottle of antibacterial soap
This process usually takes two to three hours.
You will be given instructions as to which medications you should stop taking to prepare for surgery.
On the night before your surgery, shower using half of the bottle of antibacterial soap. On the morning of the surgery, before you come to the hospital, shower using the rest of the soap.
Do not eat or drink after midnight the night before your surgery. You may take your medications that the nurse practitioner approved you to take the morning of surgery, with just a small sip of water.
Parking is available in front of the 68th Street circular entrance to the hospital. There are also several parking garages in the immediate area.
Parking is only validated on the day of your hospital discharge, not on the day of your pre-surgical appointment.
Please be sure to bring your:
• Insurance card(s)
• Toiletries
• Pajamas, robe, and slippers
Generally try not to bring too much to the hospital, because you probably won't use a lot of these things and will just have to carry them home.
Please do not bring any jewelry or expensive electronics with you for the first hospital day. Your family and friends are welcome to bring those items once you are awake and in your room.
Please check in at Greenberg 3-West (Same-Day Surgery Unit), which is on the third floor of the Greenberg Pavilion, using the "G" elevators.
If you are the first case, please check in at 6 a.m. If you are the second case, please check in at 10 a.m.
During your surgery, your family and friends should wait in the Ronald O. Perelman Heart Institute Atrium. Please tell them to check in at the front desk so that they can be contacted when your surgeon calls.
If the Ronald O. Perelman Heart Institute Atrium is closed at the time of your surgery, your family and friends may wait in the smaller waiting area right outside the Cardiothoracic ICU (4-West).
There is also a café on the first floor of the hospital, directly opposite the information desk and down the hall from the front door on the left, which is open at all times. This café sells coffee, tea, and a variety of food.
Pain in and around the incision may last up to several weeks. It is also very common to experience numbness around the incisions as well.
You will be given specific instructions about how to best care for the incisions. It is important to keep the wounds clean; normal soap and water is best for this care.
You can resume driving six weeks after your operation. Your physician will evaluate if you are ready to fly at your follow up appointment.
You will likely feel tired for a few days after the operation. We recommend taking short naps and trying to stay awake during the day as long as possible so that you can rest fully at night.
Exercise: Continue to use the incentive spirometer (the blue "ball machine") for the first week or two after you get home, approximately four to five times each day. Two weeks after surgery, you should be doing enough physical activity to stop using the machine.
Try to walk for 20 minutes twice a day when you come home, and slowly increase the frequency and duration of your exercise. You will slowly increase your endurance and energy level.
Diet: For the first one to two months after surgery, eat as much as you can without regard to salt and fat intake. In general, anesthesia will decrease your appetite, so it is important to eat as much as you can during this time to help your body to heal.
If you were on a special diet (such as a low-carbohydrate, diabetic, or kidney diet), continue following this diet after you feel that your appetite has recovered. Your care team will work with you to help determine the best diet to optimize your health.
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