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Bronchoscopy
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Advanced Bronchoscopy

Advanced Bronchoscopy

 
 
 
 
 

Overview

Advanced bronchoscopy is a specialized area within respiratory medicine, offering both diagnostic and therapeutic procedures that have significantly evolved over the past 25 years. Originally developed by Dr. S. Ikeda from Japan as a flexible alternative to rigid bronchoscopy, this technique allows clinicians to visualise the airways in real-time, even under conscious sedation. The advent of advanced imaging technologies has led to new methods of diagnosing and treating various lung conditions. Today, interventional pulmonology is a subspecialty that combines flexible bronchoscopy with cutting-edge techniques for managing complex respiratory diseases.

Professor Singh has over 30 years experience and works with other world experts in this important diagnostic and therapeutic procedure. He is widely published and will ensure patients get the most appropriate tailored approach to their clinical need.

Symptoms and Causes

Bronchoscopy is used to diagnose and treat a range of respiratory symptoms and conditions, including:

1. Breathing Difficulties:

  • Lung Cancer: Persistent cough, coughing up blood, unexplained weight loss, or recurrent respiratory infections can be signs of lung cancer. Bronchoscopy helps to visualize and biopsy suspicious areas.
  • Chronic Cough and Infections: Patients with chronic or unexplained cough, recurrent infections, or conditions like tuberculosis benefit from bronchoscopy to diagnose the underlying cause and assess airway damage.
  • Interstitial Lung Diseases: Conditions like sarcoidosis or organizing pneumonia, which affect lung tissue, can be evaluated with bronchoscopy, helping clinicians to gather tissue samples for biopsy and diagnosis.
  • Airway Obstruction: In critically ill patients or those with severe airway blockages, bronchoscopy can be used to assess and sometimes remove obstructions.

Diagnosis

Bronchoscopy is a valuable tool for diagnosing various respiratory conditions by allowing direct visualization of the airways and the collection of tissue samples. Advanced bronchoscopic techniques include:

1. Endobronchial Ultrasound (EBUS):

  • EBUS allows for the transbronchial sampling of lymph nodes located in the mediastinum (the space between the lungs). This technique is particularly useful for staging lung cancer and diagnosing diseases like sarcoidosis.

2. CT Navigation Bronchoscopy:

  • CT-guided bronchoscopy uses imaging to virtually track and mark pulmonary lesions. This technique is particularly effective in detecting lung nodules that are hard to reach with traditional bronchoscopy.

3. Fluorescence Bronchoscopy:

  • Fluorescence imaging helps identify precancerous lesions, particularly in patients who are at high risk for lung cancer. It enhances the detection of abnormal tissue that may not be visible under standard bronchoscopy.

4. Biopsy:

  • Bronchoscopy allows for tissue sampling of suspicious lung areas, which is then analyzed to confirm a diagnosis of conditions like lung cancer, tuberculosis, or interstitial lung diseases.

Treatments

In addition to diagnostics, advanced bronchoscopy is increasingly used for therapeutic interventions. These include:

1. Cancer Management:

  • Lung Cancer Debulking: For palliative care, procedures such as diathermy, cryotherapy, argon plasma coagulation, photodynamic therapy, and brachytherapy are used to reduce the tumor size and improve breathing in patients with advanced lung cancer.

2. Bronchial Thermoplasty:

  • A novel approach for treating severe asthma, bronchial thermoplasty involves applying heat to the airway walls, reducing the smooth muscle mass and preventing bronchospasm. This is still under evaluation but shows promise in managing refractory asthma.

3. Lung Volume Reduction for Emphysema:

For patients with emphysema, advanced bronchoscopy offers new treatments, such as:

  • Bronchoscopic Lung Volume Reduction: Valves are inserted into hyperinflated sections of the lung to help deflate the affected areas and improve breathing.
  • Airway Bypass: Stents are inserted in the airways to allow the trapped air in hyperinflated lungs to escape, reducing symptoms of breathlessness.
  • Endobronchial Coils: Memory coils are placed inside the lungs to reshape and reduce hyperinflation. These coils are still under trial but hold potential for improving lung function in emphysema patients.

4. Critical Care Bronchoscopy:

  • In the ICU, bronchoscopy is crucial for managing patients with acute airway obstruction, facilitating emergency procedures such as suctioning mucus plugs, removing foreign bodies, or securing airways during decompensation.

Locations

Treatments are available at the following locations:

Cromwell Hospital

164-178 Cromwell Rd,
London SW5 0TU

One Welbeck

1 Welbeck Street, Marylebone
London, W1G 0AR

London Bridge Hospital

27 Tooley St,
London SE1 2PR

Chelsea Oupatients Centre

280 King's Rd,
London SW3 5AW

Chelsea & Westminster Hospital

369 Fulham Rd,
London SW10 9NH

Sloane Hospital

125 Albemarle Rd,
Beckenham BR3 5HS

Lister Hospital

Chelsea Bridge Rd,
London SW1W 8RH

Royal Brompton Hospital

Sydney Street, London
SW3 6NP

The London Clinic main hospital

20 Devonshire Place
London W1G 6BW

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Meet Our Respiratory Experts

Prof. Suveer Singh is an experienced specialist in Respiratory Medicine, Sleep Apnoea and other Sleep Disorders (Insomnia), Respiratory Critical Care, Acute respiratory infection (including COVID) and post ITU recovery.

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Breathing Easy: Stories of Success from Respiratory Patients

Discover the inspiring narratives of individuals who have triumphed over respiratory conditions, showcasing resilience, determination, and the power of the human spirit.

It is rare to find a doctor who gives so much genuine care to a consultation. Whilst he obviously knows his craft, he took time to get to know me, my medical issues and also my concerns in a way that was more than outwardly respectful.
Exceptional professionalism and quality of care provided by Professor Suveer Singh. Appreciated his empathetic manner and quality of listening in the initial consultation, his thoroughness in testing, and his careful explanation of the analysis, test results and recommended course of action.
Dr Singh has been really dedicated and professional in his care for me. He took time to explain things that I didn't understand and was genuinely interested in diagnosing me. I am truly appreciative of his care and expertise and would recommend it.