Pulmonology

Flexible Bronchoscopy

A cornerstone of pulmonary diagnostics, flexible bronchoscopy allows direct visualization of the airways using a thin, flexible scope.

Applications:

• Evaluation of cough, hemoptysis, wheeze, and infections
• Mucus plug clearance and BAL (bronchoalveolar lavage)
• Transbronchial lung biopsies
• Foreign body retrieval

Endobronchial Ultrasound (EBUS-TBNA) with ROSE(Rapid on site evaluation)

A minimally invasive technique combining ultrasound with bronchoscopy to visualize and biopsy mediastinal lymph nodes or masses in the mediastinum and hilum. ROSE with our pathologist helps us get a on table immediate diagnosis.

Indications:

• Staging and diagnosis of lung cancer
• Sarcoidosis
• Lymphoma
• Tuberculosis or fungal infections affecting nodes

Radial Probe EBUS and C ARM guided biopsies

Used for peripheral lung nodules, a radial ultrasound probe helps guide biopsy tools accurately to lesions beyond the reach of traditional bronchoscopy. Use of C arm enhances visibility and yield.

Indications:

• Diagnosis of indeterminate pulmonary nodules
• Peripheral lung cancers
• Metastatic lesions

Electrocautery and Argon Plasma Coagulation (APC)

Used during bronchoscopy, these thermal modalities provide effective treatment for airway lesions, especially in malignant and bleeding scenarios.

• Electrocautery Applications:Tumor debulking in central airway obstruction and biopsies Treatment of benign airway stenosis
• Argon Plasma Coagulation (APC) Applications:Non-contact coagulation of superficial airway tumors Hemostasis in diffuse airway bleeding Effective palliation in advanced airway malignancies

Cryobiopsy

This technique involves freezing lung tissue using a cryoprobe to obtain larger, high- quality biopsies with minimal artifact, especially valuable in Interstitial Lung Diseases (ILDs) and Lung cancer

Indications:

• Suspected ILDs where HRCT is inconclusive
• Avoiding surgical lung biopsy

Rigid Bronchoscopy

Performed under general anesthesia, rigid bronchoscopy allows powerful therapeutic interventions for airway obstructions.

Indications:

• Central airway obstruction due to tumors
• Massive hemoptysis
• Airway stenosis, post-intubation injuries
• Stent placement
• Foreign body extraction

Airway Stenting

Silicone or metallic stents are placed to maintain airway patency in cases of malignant or benign obstruction.

Indications:

• Airway collapse (tracheomalacia)
• Malignant airway compression
• Tracheoesophageal fistula management

Management of Hemoptysis

Life-threatening bleeding is handled with expert endoscopic techniques and in collaboration with interventional radiology when embolization is needed.

Indications:

• Bronchiectasis
• TB or post-TB sequelae
• Lung cancers
• Mycetomas

Medical Thoracoscopy (Pleuroscopy)

A minimally invasive procedure under local anesthesia for examining and biopsying the pleural space using a thoracoscope.

Indications:

• Unexplained exudative pleural effusion
• Suspected pleural malignancy
• Tuberculosis
• Empyema drainage and adhesion lysis
• Talc pleurodesis

Other pleural interventions

• Pleural aspiration
• Intercoastal drainage tube insertion
• Pigtail catheter
• Indwelling pleural catheter
• Intrapleural fibrinolysis
• Pleurodesis

Advanced Pulmonary function Lab

Our department is fully equipped with advanced pulmonary function testing including PFT FENO FOT CPET DLCO Allergy testing, 6 minute walk test.

Spirometry

A non-invasive, first-line test to assess lung function, spirometry measures airflow limitation and obstruction reversibility.

Indications:

• Diagnosis and monitoring of asthma, COPD
• Occupational lung disease
• Preoperative assessment
• Chronic cough evaluation

DLCO

Assesses how well oxygen passes from the lungs into the blood. It helps detect diseases affecting the lung interstitium or pulmonary vasculature.

Indications:

• ILDs
• Pulmonary hypertension
• Early emphysema
• Monitoring systemic diseases like scleroderma

FeNO

A breath test to measure airway inflammation, particularly helpful in asthma management and steroid responsiveness.

Indications:

• Differentiating eosinophilic asthma from other causes of wheeze
• Monitoring steroid response and compliance
• Avoiding overtreatment in asthma

Cardiopulmonary Exercise Testing (CPET)

An integrated assessment of heart, lung, and muscular performance during exercise. It’s the gold standard for evaluating unexplained dyspnea.

Indications:

• Unexplained breathlessness
• Preoperative evaluation for lung resection
• Cardiopulmonary fitness for transplant
• Evaluation in heart failure, pulmonary hypertension

Forced osillometry technique

Forced Oscillation Technique (FOT) is a non-invasive, effort-independent test that measures airway resistance and reactance using sound waves during tidal breathing. Unlike spirometry, it requires minimal patient cooperation and is especially useful in children, elderly, or debilitated patients.

Indications:

• Early diagnosis of asthma and COPD
• Small airway dysfunction in smokers or post-COVID patients
• Evaluation in neuromuscular or pediatric patients
• Monitoring response to bronchodilators or inhaled therapy

FOT complements traditional spirometry and is ideal for comprehensive lung function assessment in both clinical and research settingsp