Pulmonary Special Procedures
David Duhamel, MD is one of the only pulmonologists in our region performing interventional bronchoscopy. As Director of the Pulmonary Special Procedures Unit, Dr. Duhamel specializes in treating conditions that obstruct the trachea and bronchi, including benign and malignant tumors, stenosis (constriction) of the airway, and scarring resulting from surgery or infection.
Patients suffering from cancer of the bronchial tubes or trachea are more likely to die from an inability to breathe than from the cancer itself. Now this complication can be alleviated through a revolutionary procedure known as interventional bronchoscopy. While the patient is under general anesthesia, a tube-like instrument called a "rigid bronchoscope" is inserted into the airway, through which a tiny laser tool is delivered to the site of the tumor. The laser stops the blood supply to the tumor through a process of "photocoagulation" and the tumor is removed. To prevent the airway from subsequently collapsing, a small plastic device called a stent is inserted, providing a form of scaffolding for the bronchial passage. In cases of malignancy, removal of the tumor is often followed by radiation or chemotherapy.
Interventional bronchoscopy also has applications beyond cancer treatments. The procedure can be used to remove scar tissue—resulting from bronchial infection, tracheotomy or surgical intubation—that may be obstructing an airway.
Another procedure in Dr. Duhamel's arsenal is brachytherapy, a similar treatment which delivers localized radiation to the site of a tumor through a catheter, thus protecting healthy lung tissue from unnecessary radiation exposure.
Dr. Duhamel joined the Hospital after having completed a three year fellowship at University of California—San Diego, where he received training from renowned pulmonary specialist James Harrell, MD, one of the creators of the Dumon-Harrell bronchoscope. During his tenure at UCSD, Dr. Duhamel authored an Atlas of Diseases of the Airway and an instructional DVD for new pulmonary physicians.
Dr. David Duhamel's Perspective
Interventional bronchoscopy and brachytherapy are not curative treatments for cancer, but they can significantly enhance quality of life for patients living with the disease by eliminating the need for ventilators