New Devices Help Surgeons 'Clear The Air' of Lung tumors

With the futuristic microdebrider, lung surgeons at Baylor College of Medicine in Houston can boldly go where no physician has gone before.

Used to remove tumors and other airway blockages quickly and easily, the microdebrider - a spinning surgical blade and suction device coupled with a miniature camera - represents a new wave of surgical tools that can turn the tide in patient cases with bleak diagnoses.

"In a period of about 10 minutes, we can go in and totally clean out an airway," said Dr. William Lunn, assistant professor of medicine and director of the new Complex Airway and Pleural Disease Center at BCM. "We can see what we're doing at all times, which keeps the operative field very clean."

Lunn said that some patients have been given a "grim" prognosis by previous physicians. "We look at them and say, 'We can help,'" he said.

The advent of the microdebrider and other instruments has spawned a new branch of medicine called interventional pulmonology, which can make previously invasive operations more seamless and effective to treat breathing problems.

Another new technique, called autofluorescence bronchoscopy, can detect cancer and other diseases by shining a special light in a patient's airway. Depending on the color of the reflected light, Lunn's team can immediately detect abnormal growths in the airway at a very early stage where traditional methods fall short.

"We can see lung disease and early signs of cancer that would otherwise be undetectable with a CAT scan, blood test or white-light bronchoscopy," said Lunn. "It tells us what is going on at a molecular level in the airway."

Multidetector airway CT scans, another new technology, allow Lunn and his colleagues to construct a virtual "tour" of a patient's airway passages rather than piece together separate images. Furthermore, endobronchial ultrasound images provide a map of the airway anatomy, helping his team locate a tumor's origin, for example.

"We can do ultrasound exams of the chest in our office to determine what's wrong when the patient first comes to see us," Lunn said.

BCM's multidisciplinary center, one of five in the country, specializes in treating blocked airway passages and fluid buildup on the lungs, also known as pleural effusions. Experts in the center include cardiothoracic surgeons, otorhinolaryngologists, interventional pulmonologists, and thoracic radiologists, who all regularly collaborate on patient cases.

"We see our patients together and come up with the best possible plan for each one," says Lunn.

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HOUSTON - May 10, 2005 - Baylor College of Medicine - http://www.bcm.edu