Interventional Pulmonary Procedures

The ability to perform procedures is one of the defining characteristics that attracted so many of us to fellowships in pulmonary medicine, critical care medicine, and thoracic surgery. In fact, nearly 500,000 bronchoscopies are done each year in the United States. Additionally, approximately 15,000 airway stents are placed yearly worldwide. The number and complexity of procedures that can be performed in the bronchoscopy unit is increasing. For example, endobronchial electrocautery for tumor ablation and the treatment of hemoptysis can be performed under local anesthesia during a “routine” outpatient bronchoscopy.

Unfortunately, our training and expertise is not uniform. An American College of Chest Physicians (ACCP) survey revealed that > 50% of respondents believed that their training in advanced diagnostic techniques such as transbronchial needle aspiration (TBNA) was inadequate. In another query of senior pulmonary fellows, Haponik et al found that while most fellows reported “adequate” training in bronchoscopy, only 72% had any instruction in TBNA and 27% in stent placement.

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