Innovative Treatments with Dr. Ali Saeed of Dignity Health
Interventional pulmonology uses minimally invasive robotic surgery to provide faster diagnoses, shorter stays and trusted outcomes! Norton Thoracic Institute’s interventional pulmonology team is the valley leader in minimally invasive robotic surgeries. An example of our interventional pulmonology expertise is robotic bronchoscopy, a breakthrough technique that allows our IP team to see and biopsy parts of the lung that were previously inaccessible. https://www.dignityhealth.org/arizona/locations/stjosephs/services/lung-disease-thoracic-disorders/interventional-pulmonary
Transcript
00:00 In treating conditions in the lungs and chest,
00:01 traditional surgery can have complications.
00:04 Well, Dignity Health is here to talk about
00:06 less invasive robotic surgeries.
00:08 With me is Dr. Saeed, how are you?
00:10 - I'm very well, thank you.
00:11 - Let's talk here, 'cause I was wondering
00:14 what IP is actually.
00:16 - So interventional pulmonology
00:18 is a newer field of pulmonology.
00:21 Interventional pulmonologist is a lung doctor
00:23 who undergoes an additional year of training
00:26 in minimally invasive procedures of the lung,
00:29 the lining of the lung, and the airway.
00:32 - And so with this, it's very important
00:34 to be able to help those
00:36 without so much of a major surgery, is that right?
00:39 - That is correct.
00:40 So over the last two decades,
00:42 the shift has changed from open surgeries
00:45 to minimally invasive procedures.
00:47 We want to provide the answers to the patient,
00:50 do the procedures with the least burden on the patient.
00:53 So that's the whole mantra of interventional pulmonary,
00:56 that we want to take care of a patient,
00:58 leave a minimal burden of the procedure,
01:01 get the answers, do the treatments.
01:03 - Yeah, all right, so let's talk about
01:05 what leads up to having this type of surgery.
01:07 What causes this?
01:09 - So common procedures are diagnostic procedures.
01:11 So recently, robotic bronchoscopy
01:15 has made its fame in interventional pulmonary.
01:17 It's a scope which has a 360 degree articulation,
01:22 meaning that where we park it inside the lung
01:25 or the branches of the lung, it stays there.
01:27 So we use a lung GPS to navigate to the nodule,
01:31 which is present at the very edge of the lung.
01:34 And once we go close to it,
01:37 we find the location with the help of other instruments,
01:40 like a radial ultrasound.
01:41 We even have intraoperative CT scan
01:44 at Norton Thoracic Institute.
01:46 So this helps us confirm where we are,
01:49 biopsy the nodule, minimize the complication,
01:51 and give an answer.
01:53 - I love before we came on,
01:54 you said something that was very important to you,
01:56 and that was continuing learning.
01:58 And that's one thing about you guys
02:00 are doing with this treatment,
02:01 is continuing learning and making sure
02:03 that you're taking care of the patients
02:04 and those in need,
02:06 so maybe they don't have to have that big surgery
02:07 if you guys can help it before it gets to that.
02:10 Is that right?
02:10 - Absolutely.
02:11 I use the word paradigm shift.
02:13 We are entering into a timeframe
02:15 where we are changing our approach
02:17 toward biopsying a nodule in the lung,
02:20 changing our approach towards even treatment.
02:23 Very soon, minimally invasive treatment approaches
02:26 for pulmonary nodules which have cancer hiding in them
02:29 is going to come under FDA approval.
02:32 - All right, let's talk about lung cancer
02:33 and some things that we need to understand that.
02:36 Screening for this has changed quite a bit.
02:38 We've certainly a little younger
02:40 when it's important to go get screened.
02:42 - Yes, so lung cancer, as we know,
02:45 is an aggressive cancer.
02:46 We want to fight it early.
02:48 We want to fight it aggressively.
02:50 So recently, the lung cancer guidelines changed.
02:52 Now anyone who has smoked more than 20 pack years,
02:56 meaning that they have smoked or are currently smoking,
03:01 they have age above 50
03:03 and they have not quit for more than 15 years,
03:06 they can be enrolled in lung cancer screening.
03:08 They can talk to their pulmonologist.
03:10 They can ask for our department.
03:12 We actually have a lung cancer screening program
03:14 at Norton Thoracic Institute.
03:16 - Very important.
03:17 It's very interesting.
03:18 You said something that even if they stop smoking,
03:20 it's still there.
03:21 It's kind of hidden.
03:22 Is that why this, of course, screening,
03:24 and of course what you do in the robotic sense of it,
03:27 helps get it and find it and take care of it?
03:30 - Yes, so the effect of smoking
03:32 once someone has smoked can stay there for 15 years.
03:36 So before we say that the risk of a person who has smoked
03:39 is back to a normal person who has not smoked,
03:41 it takes almost 15 years.
03:43 - Yeah, and let's talk just about a normal person
03:45 who doesn't smoke.
03:46 There's still a chance of getting lung cancer
03:48 and that's important to be screened,
03:50 even though I go, "Well, I don't smoke,
03:51 "so I don't need to get checked."
03:53 - So it's important to know your family history.
03:56 It's important to know your risk factors.
03:58 Asbestos is a risk factor there.
04:00 Radon is another risk factor.
04:02 But from a structured recommendations of screening,
04:06 smoking is a main part of the screening guideline.
04:09 - Yeah, very important there.
04:11 It's so amazing.
04:11 So again, the breakthrough in the technology
04:14 that Dignity Health is doing,
04:16 especially in the institute there,
04:17 to help fight this lung cancer.
04:19 But the big part is, of course, don't smoke.
04:22 - Yes, absolutely.
04:23 - But the other part is, go get checked out.
04:25 That is a big thing,
04:26 especially if you're feeling some of those symptoms.
04:27 And what could be some very quick symptoms
04:29 that we could be feeling?
04:30 - So, pulmonary nodules in the lung,
04:33 not all of them are cancer.
04:34 It is important that we identify a suspicious nodule.
04:38 Things which we look at on a CAT scan or a radiograph
04:41 is the edges are irregular,
04:45 or the size of the nodule is very important.
04:47 Location of the nodule is very important.
04:49 Once we take all this information,
04:51 combine it with the patient's risk,
04:53 then we make a decision whether we want to biopsy or not.
04:56 - All right, I like that.
04:57 Another quick question, very quickly, recovery.
05:00 How is recovery after this type of surgery?
05:03 - Well, you won't believe it.
05:04 Most of our patients, they recover for one hour,
05:08 go home, take it easy for one day.
05:10 Next day, you're ready to go.
05:11 - Doctor, what other type of procedures do you do?
05:13 - So, the focus of an interventional pulmonologist
05:16 is to minimize a burden on a patient
05:18 for diagnosing diseases of the lung,
05:20 the lining of the lung and the airway.
05:22 Pluroscopy, it is a procedure in which a patient
05:26 who has fluid in the sac around the lung
05:29 and the physician who's taking care of them
05:31 can't figure it out.
05:32 They refer these patients to Norton Thoracic Institute.
05:34 Interventional pulmonary and thoracic surgery,
05:37 we collaborate in discussing these patient
05:39 and finalizing a plan of care.
05:41 From a diagnostic approach, we use pluroscopy,
05:45 which is a scope with a camera at the tip of it.
05:47 We pass it from the skin into the sac around the lung.
05:50 We look at the lining of the lung
05:52 from inside the breathing muscles
05:54 and then biopsy the area of concern
05:56 and give an answer to the patient.
05:58 From diseases of the airway, we remove tumors,
06:02 we put in stents,
06:03 we biopsy hard to reach areas of the lung.
06:09 Thus, the approach is to give an answer to the patient,
06:13 provide the expertise of a multidisciplinary consultation
06:16 at the Norton Thoracic Institute,
06:18 combining interventional pulmonary, thoracic surgery,
06:22 medical and radiation oncology
06:23 are very closely in it with us.
06:26 - So it all intertwines together.
06:27 - All intertwines together to provide
06:29 a comprehensive multidisciplinary care
06:32 to our patients that are coming
06:33 to Norton Thoracic Institute.
06:34 - Wow, that's amazing.
06:36 Well, doctor, I'm so glad you stopped by here.
06:37 And of course, we have information on aztv.com
06:40 about more of Dignity Health's way to help fight cancer,
06:44 how to prevent it, and also how to take care of you.
06:46 So thank you very much, doctor.
06:47 - Absolutely.
06:48 - Thank you.
06:49 - Pleasure to be here.
06:49 - So very good.
06:51 (silence)
06:53 (silence)
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