Advanced Procedures

Our Interventional Pulmonology Program offers conventional bronchoscopic techniques and other minimally invasive procedures for diagnosing and treating lung conditions.

Conventional Bronchoscopic Procedures

Bronchoscopy is a nonsurgical, minimally invasive procedure in which your doctor looks inside your lungs with a bronchoscope — a thin, flexible tube equipped with a light and small camera. This outpatient procedure doesn’t require anesthesia, and you can go home the same day. Your doctor may use bronchoscopy to help diagnose conditions such cancer, pneumonia, tuberculosis, pneumocystis pneumonia (PCP) or another lung condition. Sometimes, having a diagnostic bronchoscopy can help you avoid surgery.

During a bronchoscopy, your doctor passes the bronchoscope through your mouth or nose, down your throat and into your airways to take a tissue sample (biopsy).

For more information about what to expect during an exam, read our frequently asked questions, or call us at 650-962-5879.

Interventional Pulmonology Diagnosis

Pulmonary health specialists use a wide range of minimally invasive procedures to visualize your internal structures, obtain tissue samples and diagnose lung disease, including:

• Electromagnetic navigation guided (EMN) bronchoscopy. This outpatient procedure is like a GPS of your airways and gives your doctor a detailed map of your internal structures. To perform the procedure, your doctor uses a bronchoscope to navigate through your trachea (windpipe) to reach targets in your lungs, such as small pulmonary nodules and lymph nodes. The procedure also can be used to place objects, called fiducial markers, if you’re having stereotactic radiation therapy to treat lung cancer. The markers show doctors where to target radiation. Our specialists have performed more than 1,000 of these procedures and train other doctors in EMN bronchoscopy.
• Endobronchial ultrasound (EBUS). Your doctor may use this procedure to take a sample of lymph node tissues. To perform the procedure, your doctor uses a bronchoscope with an ultrasound tip. We’ve performed more than 1600 EBUS procedures with no complications.
• Confocal endomicroscopy. Your doctor may use this procedure for early diagnosis of lung cancer. A thin endomicroscope (a tiny, specialized microscope) is inserted through your mouth to areas of your lungs to allow your doctor to study cells and select targeted areas for biopsy.
• Medical thoracoscopy. This procedure is used to check for pleural lung disease. Your doctor inserts a special instrument (pleuroscope) through your chest wall to obtain a tissue sample of your pleura, the tissue outside your lungs and in your chest cavity.
• Robotic-assisted bronchoscopy. Your doctor may use this minimally invasive approach to biopsy a lung nodule that’s difficult to reach. The Ion™ Endoluminal Robotic Bronchoscopy System uses a smaller, more maneuverable catheter and a flexible needle to take a sample — more accurate than a needle biopsy and an alternative to surgery.
• Transbronchial cryobiopsy. This procedure can help your doctor diagnose interstitial lung disease, such as pulmonary fibrosis. Your doctor uses a flexible cryoprobe (a surgical probe used to apply extreme cold to tissues) to obtain a tissue sample as a substitute to surgical lung biopsy. We’re a leading center for this evidence-based biopsy technique.

Interventional Pulmonology Treatments

Our pulmonary health specialists treat lung conditions using a range of advanced, minimally invasive treatments, including:

• Airway recanalization. When your windpipe is blocked due to a viral infection or tumors, your doctor can reopen the airway with an outpatient procedure called recanalization. Recanalization can improve breathing using techniques such as endobronchial cryosurgery (destroying tissue by repeated freezing and thawing), argon plasma coagulation (controlling bleeding from a lesion with the application of a gas), or laser or cryoablation (destroying abnormal cells by exposing them to a laser beam or extreme cold).
• Airway stenting. When lung cancer, tuberculosis or another condition narrows your windpipe, your doctor can open the airway using stents — tiny, flexible tubes. This outpatient procedure relieves symptoms such as shortness of breath, wheezing and lung collapse.
• Balloon bronchoplasty. A bronchoscope fitted with a tiny balloon is inflated in a narrowed area to open restricted airways. In some instances, a stent is used to hold the area open.
• Bronchial thermoplasty. If medications are insufficient in managing the symptoms of severe asthma, bronchial thermoplasty can offer a highly effective solution. This outpatient procedure is performed in three treatment sessions, scheduled approximately three weeks apart and each focusing on a different section of the lungs. During the procedure, your doctor uses a flexible bronchoscope to deliver radiofrequency energy to gently heat small sections of the airway, reducing the excessive smooth muscle to improve breathing. We perform more of these procedures than any other hospital on the West Coast and are one of only two designated physician training centers in the U.S.
• Bronchoscopic lung volume reduction (BLVR). This leading-edge approach treats severe emphysema. Your doctor uses a bronchoscope to place one-way valves in your lung airways. The valves stop air from entering the diseased part of the lungs and allow the healthy part of your lungs to expand and function better. Mountain View Hospital (El Camino Hospital) is the first hospital in California to offer this advanced treatment.
• Foreign body extraction. When you’ve inhaled food or another object into your airway, your doctor can use a bronchoscope and other tools to extract the object.
• Medical thoracoscopy. Your doctor may use this procedure to remove excess fluid (effusion) from your pleura or to remove pleural tumors. To perform the procedure, your doctor inserts a special instrument (pleuroscope) through your chest wall.
• Microdebrider bronchoscopy – A procedure used to remove debris from the windpipe and restore the airway.
• Thoracic ultrasound – A noninvasive imaging procedure that uses sound waves to visualize the structures in your chest cavity.
• Tube thoracostomy – A procedure in which a tube is inserted through the chest wall to drain air or fluid, or deliver medications.
• Valve placement for prolonged air leaks. When you have a persistent leak in your airway after surgery or ruptured blisters in your lung, your doctor can place one-way valves that can be removed once the leak is healed. Traditionally, leaks were treated with chest tubes and required prolonged hospitalization. We’re one of the few centers in the country that performs this less invasive procedure.

For more information about interventional pulmonology procedures, call us at 650-962-5879.