Hartford Hospital is one of only two medical facilities in the state utilizing a new technology that allows for minimally-invasive detection of lung cancer and assessment of its various stages. The endobronchial ultrasound system makes biopsies safer, and offers a less invasive alternative to mediastinoscopy – the surgical removal of lymph nodes for testing.
Drs. Robert Lowe and Samuel Pope of Hartford Hospital are among the first physicians in Connecticut utilizing the endobronchial ultrasound-transbronchial fine needle aspiration (EBUS-TBNA) technology. The ultrasonic bronchoscope is specifically designed to diagnose and assess cancers of the lung. The scope’s innovative design enables physicians to visualize lymph nodes and surrounding vessels in real-time, via ultrasound, while simultaneously viewing the endoscopic image.
“It’s a less invasive way of staging lung cancer,” said Dr. Robert Lowe, Vascular/Thoracic Surgeon, Hartford Hospital. “In order to treat patients with lung cancer it is important to establish the stage of their cancer at the time of presentation. Stage one to stage four treatments are very different, and the status of the lymph nodes in the lung and alongside the trachea and windpipe determines a lot. It is one more technique in our quest to more accurately diagnose the staging of patients. The more accurate the staging is, the better the results are for our patients.”
Previous to the EBUS-TBNA technology, staging lymph nodes to determine what stage a lung cancer patient was at required a small operation. Now, physicians can get that same information with this minimally invasive scope, which passes through the mouth into the trachea to visualize the lymph nodes using an ultrasound. While viewing the ultrasound picture, physicians can then advance a needle from the scope to extract lymph nodes for testing.
Not only is the EBUS-TBNA technology less risky and less invasive, it also opens up new areas for biopsy that could not be reached with traditional surgery. Operative procedures are limited by how far along the windpipe surgeons could explore. The scope allows physicians to get much further out to sample lymph nodes when working inside of the lung.
“It opens up a way to more safely get to lymph nodes in the middle of the chest,” said Dr. Samuel Pope, Pulmonary, Critical Care & Internal Medicine Specialist, Hartford Hospital. “It is a much less invasive and safer way to sample without the risks associated with surgery.”
The procedures are currently being performed under general anesthesia in the operating room with a pathologist on standby who is able to deliver real-time assessment of the quality and quantity of specimens obtained by the scope.
“Beyond lung cancer, the scope also allows you to sample lymph nodes for even non-cancerous issues like detecting tuberculosis or lymphoma instead of having to do a surgery,” said Dr. Pope.
“Prior to the scope, if we had biopsied lymph nodes through mediastinoscopy then sent the patient for pre-op treatment with radiation and chemo, trying to repeat the surgery afterward to resample the lymph nodes is very risky because the area is next to major arteries and veins, and is often scarred extensively,” stated Dr. Lowe. “Now, we can resample these lymph nodes with the scope and have a way of following the effect of the chemo and radiation to judge if surgery is appropriate. This opens up a whole new opportunity.”
About Hartford Hospital
Hartford Hospital is an 867-bed regional referral center that provides high-quality care in all clinical disciplines. Among its divisions is The Institute of Living, a 114-bed mental health facility with a national and international reputation of excellence. Jefferson House, a 104-bed long-term care facility, is also a special division of Hartford Hospital. The hospital’s major centers of clinical excellence include cardiology, oncology, emergency services and trauma, mental health, women’s health, orthopedics, bloodless surgery and advanced organ transplantation. Hartford Hospital owns and operates the state’s only air ambulance system, LIFE STAR.
