Interventional bronchology are procedures that utilise minimally invasive techniques (I.e., no cutting of the skin) with the insertion of a camera (either flexible or rigid) into the airways for both diagnostic and therapeutic purposes.
We have some of the leading interventional bronchoscopist in Australia, with expertise in various areas of diagnostic and therapeutic bronchoscopy.
The procedures that our specialists at Sydney West Respiratory and Sleep Centre is able to offer includes but is not limited to the following:
Dr Wu set up the endobronchial ultrasound guided transbronchial needle aspirate biopsy (EBUS-TBNA) Service to Westmead in 2011 and currently provides an EBUS-TBNA service through both the Westmead Public Hospital and Westmead Private Hospital. Both Dr Wu and Dr Roy are skilled at performing EBUS. This is a technique for safe biopsy of lymph nodes in the chest under ultrasound guidance through a camera via your air pipes, which is commonly used for lung cancer diagnosis and staging (i.e., has the cancer spread into the lymph gland). Endobronchial ultrasound can also be used in the diagnosis of other diseases of lymph nodes in the chest, such as sarcoidosis, tuberculosis or lymphoma. Endobronchial ultrasound can also be used to sample and diagnose cancer that is close to the airways located centrally.
For cancer that are located further away from the central airways, radial endobronchial ultrasound is another technique that can be used for the diagnosis lung lesions more towards the edge of the lung (peripheral lung nodule or PLN) and are most ideally used for those where the airway runs through the middle of the cancer.
Dr Wu is currently also involved in trials of bronchoscopic lung volume reduction surgery using endobronchial valves in select patients with severe emphysema/ chronic obstructive pulmonary disease (COPD)/ chronic airways limitation (CAL). Endobronchial valves are designed to collapse the damaged emphysematous parts of the lung, in order to allow the remaining good parts of the lung to work better. This has been shown to improve function, reduce breathlessness and improve quality of life of patients.
Similarly, for diseases that causes air leak from the lungs, Dr Wu is experienced at using endobronchial valves to block off the air pipe that is leading to the lung that is causing the air leak, thus reducing the amount of air escaping out, to allow a better opportunity for spontaneous healing. This is called using an endobronchial valve for an alveolar pleural fistula.
Dr Wu is skilled in performing transbronchial lung biopsy, which is using a forceps via the bronchoscope to go towards the edges of the lung, to take samples of the lung under real life X-ray guidance. This technique is useful for diagnosed a progress that involves a large part of the lung such as sarcoidosis, tuberculosis, lymphangitis carcinomatosis, respiratory-bronchiolitis interstitial lung disease, hypersensitivity pneumonitis and organising pneumonia, amongst many other conditions. Dr Wu has also participated the nationwide trial using transbronchial cryobiopsy called COLDICE trial, which is using a frozen probe to take bigger pieces of the lung, in order to make a more accurate diagnosis, without the patient having to experience any cuts.
Sometimes, interventional pulmonology acts in collaboration with minimally invasive thoracic surgery (video assisted thorascopic surgery or VATS), using special computer software and accurate mapping processes to find small nodules/lung cancer and staining them, to allow a thoracic surgeon to more accurately located and resected lung cancers, whilst sparing the good tissue.
In addition, Dr Wu has unique skills in rigid bronchoscopy, laser bronchoscopy, cryorecanalisation of the airways and the insertion and removal of silicone and metallic stents, which are techniques that are used to treat both malignant and non-malignant major/central airway obstruction.
Dr Wu has a weekly bronchoscopy list at Westmead Public Hospital on Monday mornings, and a fortnightly bronchoscopy list at Westmead Private Hospital on Fridays. Dr Roy has a weekly bronchoscopy list at Westmead Public Hospital on Wednesday mornings. The bronchoscopic procedures will usually be performed as a day-only procedure. More complex bronchoscopic procedures may require overnight admission to Westmead Public Hospital or Westmead Private Hospital.
