Interventional Pulmonology

Roswell Park's Interventional Pulmonology services uses endoscopy and other minimally invasive techniques to diagnose and treat conditions in the lungs and chest.

Our Endoscopy Center brings together Advanced Endoscopy and Interventional Pulmonology services into one state-of-the-art facility where more than 90 percent of procedures are performed on an outpatient basis. With our unique capabilities, we offer minimally invasive options in place of traditional surgery whenever possible, caring for patients in a way that affords a quicker recovery, less pain and fewer side effects.

Conditions We Treat

Lung nodules, or “spots on the lung,” are nodules that show up on chest x-rays or CT scans. These are a source of great distress for patients and family members. Most lung nodules are benign, but some have a higher chance of being cancer. Using advanced techniques like endobronchial ultrasound and robotic endoscopy, we can accurately identify and biopsy to determine what the nodules represent and whether further treatment is needed.

Many health conditions cause the lymph nodes of the chest to enlarge. Endobronchial ultrasound is one of the most effective methods available to evaluate these lymph nodes. It allows us to take tissue without incisions or pain to the patient. Using various imaging techniques, we can work with you to determine the best course of action.

Central airway obstruction, both malignant and non-malignant, causes significant difficulty with breathing and distress in patients. We work to determine and treat the causes of airway obstruction. The placement of stents in the airways can help to hold them open and help to maintain normal breathing. We offer several minimally invasive endobronchial treatments that can immediately open blocked or narrowed airways, and improve ability to breathe, come off a ventilator or undergo additional cancer treatment.

Bronchopleural fistulas and persistent air leak can occur after major surgeries of the chest or can occur after a pneumothorax. We work to determine likely causes of the air leak and to isolate the section of the lung where the air leak is originating from. Once we identify this, we can work to stop the leak using endobronchial valves or other therapies. Often we are able to fix the air leak with a single treatment, allowing patients to go home faster.

There are many causes of fluid collections within the chest. Some of these are related to benign conditions while others are related to cancer, including lung cancer, breast cancer, lymphoma and others. In the Thoracic Medicine Clinic and Endoscopy Suite, we can work to determine the cause of pleural effusions and remove them, allowing for easier breathing. In certain conditions, we recommend the placement of special catheters to drain the fluid collection outside of the hospital (tunneled pleural catheters). In others, we recommend a biopsy of the edge of the chest wall from the inside (pleuroscopy).

Advanced emphysema causes anxiety and breathlessness because patients are unable to breathe effectively with their diaphragm (breathing muscles). At Roswell Park, we can help to evaluate patients for placement of one-way endobronchial valves. These valves can help to block air from going to the most diseased area of the lung. As these areas deflate, the healthier areas of lung can be better used to improve a patient’s breathing. These valves have been shown to improve lung function tests, and more importantly, quality of life. Two valves (the Zephyr valve by PulmonX and Spiration valves by Olympus) are commercially available. At Roswell Park, we can assist in the evaluation and placement of both types of valves.

In certain patients who have asthma, there are few therapeutic options available. One option is to treat one of the major causes of severe asthma; airway smooth muscle. Using a type of catheter called the Alair catheter, we can treat the airway smooth muscle in small to medium-sized airways. This is done over three bronchoscopies and has been shown to reduce the need for steroids and reduce severe asthma exacerbations.