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Role of the Interventional Pulmonologist

Interventional pulmonology is an expanding area of pulmonary medicine focused on the use of bronchoscopic and thoracoscopic techniques for the diagnosis and treatment of upper airway disorders and pleural diseases. The types of procedures that are incorporated into this field are rapidly increasing as we gain more experience in the management of these pathologies. The field of interventional pulmonology includes several endobronchial techniques that are used to relieve obstruction of the trachea and large bronchi secondary to either a benign or malignant process. Balloon dilation, cryotherapy, endobronchial laser therapy, electrocautery, brachytherapy, and stent placement are all frequently used in the management of these disorders. Each technique has a unique set of characteristics that may make it the more or less appropriate modality to use for a specific patient or condition. More often than not, these techniques are used in combination for the best outcomes. These procedures are performed using either rigid or flexible bronchoscopy, depending on the particular patient and disease process involved, as well as the operator's experience. Pleural disease is a common and challenging component of pulmonary medicine, as well as a major source of morbidity. Medical thoracoscopy is being used more frequently to effectively evaluate and treat pleural disorders. This review discusses the patient selection criteria, the endoscopic or thoracoscopic techniques used, as well as the management strategies that the interventionalist uses when caring for patients with these disorders.