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Evropis pirveli kongresi bronqologiasa da intervenciul pulmonologiaSi profesori kaxa vaWaraZe eq.bronqologi daviT Wyonia.

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Presentation on theme: "Evropis pirveli kongresi bronqologiasa da intervenciul pulmonologiaSi profesori kaxa vaWaraZe eq.bronqologi daviT Wyonia."— Presentation transcript:

1 evropis pirveli kongresi bronqologiasa da intervenciul pulmonologiaSi profesori kaxa vaWaraZe eq.bronqologi daviT Wyonia

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3 marseli marti 2011weli

4 kongresis Catarebis adgili faros sasaxle

5 monawileebi

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7 mTavari darbazi

8 axli meTodebis aTviseba muliaJebTan

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10 Stefano Gasparini -s gamocdilebis gaziareba

11 Kazuchiro Yasufuku EBUS- is Convex zondebis Semqmneli

12 Yoichi Watanabe- bronqoblokatorebis Semqmneli

13 Semra Bilaceroglu, me - 2 kongresis da EABIP -is mdivani

14 ruseT-saqarTvelos urTierTobebis aRdgena

15 ZiriTadad ganxiluli Temebi bronqoskopia diagnostikuri samkurnalo Torakoskopia (plevroskopia) diagnostikuri samkurnalo axali teqnologiebi diagnostikuri samkurnalo

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19 The semirigid pleuroscope is shown. Ernst A et al. Chest 2002;122: ©2002 by American College of Chest Physicians

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25 Electromagnetic Navigation Bronchoscopy (ENB) Procedure Overview CT-Scan DICOM CD Planning Software Planned Pathway File Navigation BiopsyTreatment

26 Electromagnetic Navigation Bronchoscopy (ENB) Procedure Overview Locatable Guide (LG): 360° steerability for navigation to lesions and lymph nodes Extended Working Channel (EWC): Lock EWC in place for insertion of biopsy tools and other catheters Patient Sensor Triplets: Placed on patient and are tracking sensors to show LG position and account for patient movement Location Board: creates electromagnetic field Bronchoscopic Access: LG and EWC go through mouth/nose to steer through bronchial tree to lesions and lymph nodes Planning Screen Image copyright of superDimension, Ltd Access to lung targets with GPS-like navigation Planning Phase: Visualize lung anatomy and airways in 3D Mark the target nodule and plan the pathway Procedure Phase: Steerable catheters and electromagnetic technology provide real-time guidance and access to targets in the lung Navigation Screen

27 © by CARL REINER Jet-Laryngoscope Jet-Bronchoscopes The Jet-Endoscopes

28 © by CARL REINER Tubeless Jet-Ventilation  No tube in surgical field!  Unlimited sight upon surgical field on Larynx and Trachea  More space for manipulation!  Laser application without risk!  No risk of barotraumas!  No Tracheostoma necessary!  No time limit!  Intraveneous Anaesthesia- easy Narkotic-handling  no exposure narcotic gas

29 Results endoscopic treatment p=0,034 Therapeutic helium - neon laser: - wavelength nm - quartz electrode (2,6 mm) - radiation power up to 100mW Equipment

30 Restenosis after endoscopic treatment Restenosis after laser irradiation Restenosis without laser irradiation

31 TB Carcinoid Cancer TB Carcinoid Cancer Broncolith TB TOOTH T o B e or Not T o B e – That is the Question !

32 TB or Not TB TB Cancer Granulom. Inflammation TB Cancer Granulom. Inflammation TB Rhizopus

33 Types of Endobronchial TB 1. Edematous-Hyperemic 2. Actively Caseating 3. Fibro-Stenotic 4. Tumorous 5. Granular 6. Ulcerative 7. Non Specific Bronchitic Bronchoscopic Assessment of the Evolution of Endobronchial Tuberculosis Hee Soon Chung et al CHEST Feb 2000 : Vol117 No

34 Conclusion Endobronchial Tuberculosis is a great masquerader and can mimick fungal infections, sarcoidosis, foreign bodies carcinoid or even malignancy Endobronchial Tuberculosis is a great masquerader and can mimick fungal infections, sarcoidosis, foreign bodies carcinoid or even malignancy Biopsy confirmation is necessary in most cases to make a definitive diagnosis Biopsy confirmation is necessary in most cases to make a definitive diagnosis There are seven types of EBTB described which actually reflect the various stages of evolution in the disease and have varying prognosis There are seven types of EBTB described which actually reflect the various stages of evolution in the disease and have varying prognosis A Bronchoscopist is often faced with the dilemma A Bronchoscopist is often faced with the dilemma TB or not TB ! TB or not TB !

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38 gmadlobT yuradRebisTvis!


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