Pneumology
Created in 1994, the Pneumology service at Clínica São Vicente became a reference centre of this specialty. Specialized professionals, in the surgical centre and with the entire infrastructure offered by Clínica São Vicente, make the Bronchoscopy a totally safe exam. The Pneumology centre operates 24 hours and frequently works with the Intensive Care Unit, on the cases that demand urgent interventions.
What is the exam?
Among the most common indications for the diagnostic Bronchoscopy are the investigations related to coughing, the presence of lesions in the thorax radiography, nodes, suspecting tuberculosis and pneumonias, extracting secretion for analysis and the extraction of foreign bodies that have been inhaled or swallowed by patients. The Bronchoscopy might be therapeutically indicated in the cases of malignant diseases, such as cancer, and benign such as tumours, pneumonias and others. The exam is quick, lasting approximately 10 minutes. The patient is given general or local anaesthesia to avoid pain or lack of comfort such as a vomiting sensation and coughing. It can be conducted with three types of devices:
- Flexible bronchoscope
This is a very thin and flexible tube, manufactured with optic fibres, that is introduced by the mouth or nostril, reaching the lungs, following the same path made by the air we breathe. A micro-camera can be connected to it, allowing the exam to be video-taped or to take snapshots.
- Video-bronchofiberscope
This equipment also uses flexible tubes and has a computerized system, which generates images with much higher definition, improving the view of the area where the procedure will be performed.
- Rigid Bronchoscope
This rigid tube has small orifices used to introduce equipment to perform a surgery and to remove strange objects. Under general anaesthesia, it is inserted through the mouth and reaches the tracheae and the lungs.
After each exam, the equipment undergoes a decontamination process in a chemical solution.
Pulmonary function tests or Spirometry
This test has the purpose of evaluating the volume of the lungs and the speed in which the air goes through the respiratory system. Following the physician’s instructions, the patient inhales and exhales through equipment with a pressure sensor that sends data that can reveal the effects of many conditions, such as smoking, chronic obstructive pulmonary disease (COPD) and bronchial asthma, among others. It is also used on patients who will undergo thorax surgery and for admission exams, for the evaluation and diagnosis of respiratory diseases related to a professional activity. The accurate result depends on the quality of the equipment and standardized techniques, but mainly on the qualification of the professional, apart from the strict involvement of those undergoing the test.
The Bronchoscopy and Spirometry are complementary with other methods to diagnose diseases, such as blood tests, radiography and tomography.
Percutaneous Tracheostomy
The indications are basically the same as that of the open Tracheostomy, such as removing an obstruction of the respiratory tract, in cases in which other methods are not recommended, and for patients who need mechanical ventilation for a long period of time. In Percutaneous Tracheostomy, a technique considered quick and safe, the surgeon uses a kit that is specific for this procedure that consists in a punch to the trachea and dilating it without the cuts needed in conventional surgery.