It is no exaggeration to say that the Department of Pulmonology of Sri Ramakrishna Hospital is among the foremost of its kind in the country. Our equipment, facilities and expertise in diagnosing and treating diseases of the respiratory tract have been set to global benchmarks. We were the first in India to have an exercise physiology test system with breath-to-breath analysis of respiratory gases.
We routinely perform bronchoscopies, thoracoscopies, pleural drainage procedures, pleurodesis, CT guided FNAC (fine needle aspiration cytology) and FNAB (fine needle aspiration biopsy).
Patients suffering from hemoptysis benefit from bronchial artery embolisation while those affected by diffuse lung disease benefit from cryobiopsies. If you suffer from pulmonary disorders, we can and will help you.
Treatments & Procedures
A bronchoscopy is a procedure performed in the lungs for various respiratory disorders. It can be diagnostic as well as therapeutic. During the procedure a ‘bronchoscope’ is inserted into the airways and assessed. This is a tube with a camera at the end of it. It also has a working channel through which thin instruments like biopsy forceps can be introduced for taking a biopsy. There are two types of bronchoscopes – flexible and rigid. Traditionally, a rigid bronchoscope was used which required general anesthesia. Today however, the flexible video bronchoscope is most commonly used. It bends easily and allows the bronchoscopist to visualize even distal airways.
Bronchoscopies are routinely performed by pulmonologists at Sri Ramakrishna Hospital for the following conditions:
- Hemoptysis of uncertain origin
- Evaluation of lung mass
- Staging of Brochogenic Carcinoma
- Non resolving consolidation
- Evaluation of sarcoidosis
- Interstitial Lung Disease (ILD)
The following diagnostic procedures are done in our Hospital:
- Bronchial washings, Brushings
- Brochioalveolar Lavage
- Endo bronchial biopsy, Trans Broncial Lung biopsy
- Trans bronchial Needle Aspiration
We offer Therapeutic Bronchoscopy for the following conditions:
- Bronchoscopy guided Endotracheal Intubation
- Bronchoscopy guided Tracheostomy
- Removal Foreign body & mucus plug
- Debulking of Endobronchail Tumor
- Ballon dilation of Stenotic airway
- Stent placement for stenotic airways & Tracheo Oesphageal Fistula(TEF)
This is a procedure by which a bronchioscopist collects specimens from the distal most airways. Aliquots Saline is instilled into the affected segment via the working channel of bronchoscope then suctioned back. The retrieved fluid is then sent for various microbiological analysis & cytology. This is an excellent diagnostic tool for cancer and infections.
Sri Ramakrishna Hospital routinely uses this procedure for histopathological diagnosis of diffuse parencymal lung disease. In this procedure, forceps is passed through the working channel in the bronchoscope at the point of concern with the help of biopsy forceps. Biopsy of affected lung tissue is done. The biopsy sample is then sent for pathological examination.
In certain cases, the specimens obtained in a transbronchial lung biopsy are inadequate or insufficient to diagnose certain conditions. The specimens which are obtained by the forceps are too small for diagnosis of diffuse lung disease. However, the latest technology has provided us with a far more effective new option. Sri Ramakrishna Hospital offers its patients the advantages of cryobiopsy. A flexible ‘cyroprobe’ is guided to the location from which a specimen is required. It is then cooled using a variety of technologies. This cooling freezes the tissue of the lungs in the immediate region and it adheres to the tip of the probe, after which it is retracted. The size of the specimen obtained by this method is consistently larger than in the traditional way and accuracy of diagnosis has been proven to be much higher.
Endobronchial Ultrasound (EBUS) guided Transbronchial Needle Aspiration (TBNA)
Known as EBUS TBNA for short, this is a specialised technique used to obtain body tissue samples from Thoracic Lymph Nodes. It uses a special type of bronchoscope, which has ultrasound at its tip. In conventional TBNA, the procedure is done without guidance of Ultrasound. In EBUS guided TBNA, the procedure is guided by Ultrasound, hence diagnostic accuracy and yield is much better.
It is a condition where segment of airway is narrowed which It obstructs air passing to the lungs. Some of the symptoms of airway stenosis can be hoarseness, wheezing, respiratory distress and shortness of breath. Sometimes it can be so severe that a patient may require a tracheostomy tube to even breathe. While there are open surgical procedures to treat this condition, one of the new, more effective and least traumatic techniques is balloon dilation. Dilation means ‘opening’ and, as the name indicates, in this case a specialised balloon is utilised to increase the size of the passage allowing the patient to breathe more freely. There it is inflated for a short period of time to dilate the stenotic airways. The procedure is minimally invasive and the patient may not even be on general anaesthetic. This procedure might be followed up with the placement of a stent to present sequence.
A thoracoscopy is a minimally invasive procedure used for both diagnostic and therapeutic purposes. A thoracoscope (a thin, flexible tube with a camera) is inserted into the Pleural Cavity via an incision so that both visceral and parietal pleura (a membrane covering the lungs) are examined.
It conducted for the following conditions:
- Pleural Biopsies for diagnosis of mesothelioma and malignant pleural effusion
- To remove excess air or fluid from the region surrounding the lungs
- To remove pleural cysts or diseased lung tissue
- To lyse the adhesion in the pleural cavity secondary to complicated parapneumonic effusion and
- Pleurodesis – Procedure by which Talc is insufflated into the Pleural cavity to prevent recurrence of
- malignant pleural effusion (accumulation of liquid in the pleural cavity secondary to malignancy)
- Pneumothorax (accumulation of air in the pleural cavity)
When a person coughs up blood it is known as haemoptysis (or hemoptysis). This can be due to various causes like infection, cancer, aneurysm (dilation & thinning of blood vessel) and bronchiectusis (dilation & destruction of bronchus). Haemoptysis is a medical emergency and requires immediate attention, evaluation and treatment. Bronchial artery embolisation is one of the more advanced techniques practiced at Sri Ramakrishna Hospital to stop hemoptysis. It is a minimally invasive procedure. The doctor inserts a catheter into an artery in the leg, which is then guided up to the lungs. A dye is injected to identify the source of the bleeding. The affected artery is then blocked through the use of metal coils or other techniques and substances. This stops the bleeding. The blocked artery is not a concern since other arteries immediately compensate for it.
FNAC and FNAB are procedures wherein cells or tissue are removed from the body for pathological examination. Lung biopsies can now be performed using a minimally invasive technique under CT guidance. A fine needle with a hollow end is inserted into the lung mass / nodule and Tissue obtained. This can be done without a patient having to be on general anaesthesia. The aspirate (FNAC) is made into smears for cytological evaluation and the tissue (biopsy specimen) taken is subjected for pathological examination.
Our Pulmonology department is well equipped with following test
- Body box
- Co-diffusion capacity measurement
- Cardio pulmonary function test.
Pulmonology department has well equipped sleep lab. Patients with suspected sleep related breathing disorder like OSA were subjected for sleep study. Titration sleep study is done for patients who require CPAP energy.
- Behavioral Intervist works as a Team in smoking cessation program.