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Interventional Pulmonologist and the Surgeon – A Symbiotic Relationship

By September 7, 2018volume1-issue1
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Ajay Narasimhan: Interventional Pulmonologist and the Surgeon – A Symbiotic Relationship

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Interventional Pulmonologist and the Surgeon – A Symbiotic Relationship

Hans Christian Jacobeus in 1910 first used the cystoscope to view the thoracic cavity in a patient with tuberculosis and pleural adhesions. He is considered the founding father of thoracoscopy and laid the principles for the field of interventional pulmonology. However, this method was used only for a few years and then abandoned. The subsequent years saw the field of pulmonology being reduced to pthisiologists.

Over the last two decades we have seen the reemergence of interventional pulmonology as a separate specialty. The initial group of interventional pulmonologists limited themselves to endobronchial ultrasound for mediastinal adenopathy, placements of airway stents in benign and malignant airway disorders and removal of foreign bodies. With improvements in optics and newer technologies, there was a renewed interest in rigid bronchoscopy, thoracoscopy and expanded the horizon into non conventional areas. These new developments in the medical field has helped patients to a great extent but also raised some concerns in the mind of the thoracic surgeon.

Navigational bronchoscopy is another new tool which allows precise targeted biopsies of areas
of the lung which can otherwise be accessed only surgically. The advances in interventional pulmonology may have reduced the need to perform unnecessary surgical procedures. In a hospital where we are all working for our financial reward, this leads to a fight for the bread andbutter. In certain institutions where dedicated endoscopy suits are not available, the so called “medical people” are not allowed to use the theatre for their interventional procedures and are considered outcasts. The situation is changing though.

The interventional pulmonologist should realize that there are certain conditions which might be beyond the scope of a physician and may require the services of a surgeon. At the same time, the thoracic surgeons need to acknowledge the invaluable role of the interventional pulmonologist in diagnosis and palliative care of lung cancer patients and airway disorders.

To overcome this problem many centres have introduced the concept of a multi-disciplinary team consisting of a pulmonologist, thoracic surgeon and a radiologist. This team approach will lead to improvement in patient care and also the relationship between the interventional pulmonologist and the thoracic surgeon.

How to cite this article: Ajay Narasimhan, Interventional Pulmonologist and the Surgeon – A Symbiotic Relationship, JAPT 2018; 1:24

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