Invasive Bronchoscopy Program

The Interventional Pulmonary Service at The Mount Sinai Medical Center supports all state-of-the-art diagnostic and therapeutic procedures necessary to care for patients with advanced pulmonary diseases. Both rigid and fiberoptic bronchoscopes are employed in diagnosing and treating patients with endobronchial and pulmonary parenchymal disease. More than 400 fiberoptic procedures are performed each year. Extensive experience in bronchoalveolar lavage, transbronchial biopsy, and transbronchial needle aspiration (Wang) provides for a high percentage of diagnostic success with low associated morbidity and mortality. Fluoroscopic transthoracic needle aspirations for the diagnosis of peripheral lung nodules are routinely performed and are associated with a diagnostic rate of 90 percent with lower than expected associated pneumothorax complications.

Therapeutically, both the flexible and rigid bronchoscope are employed in the care of patients with endobronchial obstruction. Removal of foreign bodies, endoscopic laser resection of obstructing endobronchial tumor and placement of endobronchial stents are routinely performed. In collaboration with ENT and the Department of Cardiothoracic Surgery, more than 30 endoscopic laser resections (YAG and CO2 laser) of airway tumors are performed annually. Patients judged to be appropriate candidates are evaluated for endoscopic brachytherapy or stent placement. We have extensive experience with a variety of silicone and expandable stents (Wallstent, Palmalz, Ulraflex, etc.) used in the treatment of both malignant and benign disease. We have successfully performed 20-25 procedures within the past two years.