Interventional Pulmonology

How is Interventional Pulmonology Different at Hoag?

Hoag has been Orange County’s leader in the advanced diagnosis and treatment of respiratory-related disorders for decades. With the introduction of our new Interventional Pulmonology program, we take that commitment to excellence to the next level. At Hoag, our team includes the area’s only practicing Interventional Pulmonologist, and the next-generation treatment and interventional options that can make a real difference in outcomes, recoveries and patients’ lives.

Fully-Integrated Teams and Treatment

One important way Interventional Pulmonology at Hoag is different is that our IP team is fully integrated with the Hoag Family Cancer Institute. While not every respiratory condition is cancerous, that integration gives our Interventional Pulmonology program instant access and communication with the area’s most experienced and highly trained thoracic surgeons, radiation oncologists and other specialists. Collectively, they’ve spent decades studying and treating conditions of the lungs and airways, including contributing to many of the treatments and minimally-invasive techniques used around the world. The result: a team that’s always looking for the best and most appropriate path forward for every patient, from diagnosis to recovery.   

What is Interventional Pulmonology?

Pulmonology is a field of medicine that specializes in the diagnosis and treatment of disorders related to breathing and the respiratory system, including the lungs, airways, breathing-related blood vessels and thoracic cavity, which is the area inside your upper chest that contains the lungs, heart and other organs. In the past, treating these conditions often required invasive surgery that could extend recovery time to weeks or months.

Interventional Pulmonology is a different approach to treating and managing conditions of the respiratory system. While still a relatively new field, Interventional Pulmonology is dedicated to less-invasive methods of diagnosing, treating and managing lung and airway disorders and the symptoms of these conditions.

Rather than major surgery, Interventional Pulmonology utilizes next-generation imaging and techniques like advanced, guided bronchoscopy to improve outcomes and shorten hospital stays and recovery times. These efforts are overseen by a team of oncologists, thoracic surgeons and other specialists who are highly trained in this less-invasive approach.

At Hoag, advanced techniques utilized by our Interventional Pulmonology program include advanced endoscopic surgery, which is performed by passing small instruments and cameras into the thoracic cavity through small incisions, and robotic-assisted bronchoscopy with three-dimensional guidance, in which a camera is passed down the throat and into the respiratory system so the lungs and airways can be directly viewed by physicians.   

What conditions can be treated through Interventional Pulmonology?

Many chronic conditions of the lungs and airways can be successfully treated and managed by Interventional Pulmonology. Conditions that can potentially be diagnosed or treated through Hoag’s Interventional Pulmonology program include:

  • Cancer that originates in the lungs (primary lung cancer) or which has spreads to the lungs (metastatic lung cancer)
  • Tracheal cancer
  • Emphysema
  • Chronic Obstructive Pulmonary Disorder (COPD)
  • Pleural disorders, which affect the tissue that lines the inside of the thoracic cavity and the exterior of the lungs
  • Malignant and non-malignant airway obstructions
  • Severe asthma
  • Pneumothoraces, K.A. “collapsed lung”
  • Bronchopleural fistulas, which are abnormal connections that can form between passages in the lungs
  • Chronic cough or chest pain
  • Tracheal and bronchial stenosis, which is an abnormal narrowing of the trachea and/or bronchial tubes that transmit air into and out of the lungs
  • Recurring shortness of breath
  • Dynamic compression of the airways, which can cause a person’s airways to narrow or collapse
  • Inflammation or bleeding in the airways and lungs
  • Mediastinal adenopathy (AKA lymphadenopathy), which is caused by enlarged lymph nodes in the chest
  • Pulmonary nodules, which are abnormal growths that form in the lungs
  • Suspect masses requiring biopsy in the lungs or thoracic lymph nodes

Tomorrow’s Techniques, Today

Interventional Pulmonology is about responsibly pushing the boundaries of medicine and techniques to help patients in ways that would have been simply impossible even a few years ago. Among the next-generation approaches employed by Interventional Pulmonology at Hoag:

  • Cion Spin: Hoag is the first hospital in Orange County to offer Cios Spin®, a technology that diagnoses lung cancer earlier, more accurately and less invasively – so you can get back to your life that much sooner.
  • The Ion by Intuitive Robotic-Assisted Bronchoscopy Platform: Hoag is proud to be one of the few Interventional Pulmonology programs in the U.S. to offer Ion Robotic-Assisted Bronchoscopy. It’s a robot-enabled technique that allows for safe, minimally invasive collection of tissue samples for biopsy by passing instruments down the windpipe, even when lesions are deep in the lungs. Ion’s thin and maneuverable catheter allows clinicians to reach small lesions in all 18 segments of the lung, without invasive surgery or needle biopsies that puncture the skin. Learn more about robotic-assisted procedures at Hoag.
  • Cone-Beam Computed Tomography (CBCT) with 3D Fluoroscopy: (Coming Soon) Hoag is one of the few centers in the nation to offer Cone-Beam Computed Tomography (CBCT) with 3D Fluoroscopy for lung conditions. It’s an advanced imaging technique that creates three-dimensional (3D) images of tissues inside the body. This enhanced imaging allows for easier treatment and ablation of tumors of the lung. In addition to utilizing radiation exposures that are up to 10 times less than conventional CT scans, CBCT is also much faster than conventional CT.
  • Convex-Probe Endobronchial Ultrasound Bronchoscopy (CP-EBUS), which is a revolutionary form of bronchoscopy that incorporates a convex ultrasound transducer into the tip of the bronchoscope, which is a small, flexible camera passed down the throat and into the airways. Incorporating ultrasound gives specialists real-time guidance when obtaining tissue samples from deep in the lungs, allowing sampling to be more precise. Though CP-EBUS allows advanced diagnosis of different types of pulmonary disorders, including infections and inflammation, it is particularly useful in the diagnosis and staging of lung cancer.
  • Radial-Probe Endobronchial Ultrasound Bronchoscopy (RP-EBUS), which is another advanced, highly accurate form of guided bronchoscopy. Unlike CP-EBUS, RP-EBUS involves a rotating ultrasound source that’s passed through the bronchoscope. This allows pulmonary nodules and other issues to be detected with much greater accuracy, without the need for radiation-based imaging.
  • Cryoablation, which is a technique that utilizes localized, extreme cold to treat certain cancers, including lung cancer that may have been deemed inoperable. During the procedure, a thin instrument known as a cryoprobe is inserted through a bronchoscope until it comes in direct contact with the cancerous or benign tumor or lesion. Gas is then used to reduce the tip of the cryoprobe to below freezing, destroying cancerous cells through repeated freezing and thawing cycles.
  • Zephyr Valve Treatment: One of the most advanced treatment options for those with chronic shortness of breath, the Zephyr® Valve system is the first FDA-approved device in the U.S. for treating patients with severe emphysema. The treatment involves using minimally-invasive techniques to place tiny valves in a patient’s airways. These valves allow healthy parts of the lung to expand, which can greatly enhance patient comfort and breathing function.