New Patient Consultation
We Provide The Highest Quality Respiratory Medical Care with Pioneering New Treatments. Professor Pallav Shah is a specialist with over 20 years of expertise in all aspects of respiratory disease. He has a particular interest in Bronchoscopy, Lung Cancer, COPD, & Asthma. He is experienced in managing complex and rare conditions
Follow up Consultation
Follow up visits after investigations and also reassessment to evaluate treatment response. the follow up visits are important for chronic conditions to ensure you stability and optimal most advanced care.
Second Opinion Service
A comprehensive second opinion service is available. Please forward all the clinical information including medical history, past medical history, current drugs and the results of any test already performed. Any X-rays and scans need to be submitted in a digital format as DICOM files. These can all be submitted via a dropbox account firstname.lastname@example.org
The initial fees include a telephone or personal consultation. However, any additional investigation or follow up visits required are NOT included.
Bronchoscopy is a procedure whereby the windpipe (trachea) and the main branches of the airways (bronchi) can be visualised using a long flexible tube, with an integrated camera system. The bronchoscope also has an instrument channel that allows secretions to be suctioned and instruments to be passed through for a variety of tasks.
The repeated branching of the airways from the windpipe creates a complex structure. Hence, when an abnormal area is further out in the lung it becomes increasingly difficult to reach it. Navigation Bronchoscopy uses the CT scan and other technologies to guide the camera to the abnormal area. It is a little like SatNav in the lung and works by using slimmer bronchoscope with different tools like electromagnetic sensors and ultrasound.
This technique is used to treat asthma and involves using radio-frequency energy to heat up the airway tissue by a controlled amount so as to kill of the smooth muscle in the airway. In asthma there is excessive smooth muscle and the constriction of this smooth muscle induces narrowing of the airways. This in turn causes wheezing and breathlessness and can be reduced by bronchial thermoplasty.
EndoBronchial Ultrasound (EBUS)
This procedure is performed with a more complex camera which has ultrasound built into it. This allows the area adjacent to but outside the main airways to be visualised. This technique is particularly useful for sampling lymph glands which sit outside the lungs in the central part of the chest but are adjacent to the main windpipe and airways. Under direct vision with the ultrasound a fine needle can be inserted into the gland and a small biopsy can be obtained for analysis in the pathology laboratory.
Lung Volume Reduction
Patients with emphysema may benefit from treatments aimed at reducing the lung volumes. This can be achieved by a number of methods using therapeutic bronchoscopy. Insertion of endobronchial valves is considered standard of care by the National Institute of Clinical Excellence (NICE). Other techniques include the insertion of endobronchial coils. Vapor treatment using thermal energy to scar a section of lung can also reduce the lung volume.
This procedure involves using a freezing the tissue to below -30oC. It can be used to remove tumours growing in the main airways. The cryoprobe is passed through the bronchoscope and applied to areas of abnormal airway, lung or tumour. The freezing process causes the some of the tumour to stick onto the probe and this can then be removed from the airway. Repeated application can allow tumours blocking some of the air passages to be removed. This opening up the air passages should lead to improvements in breathing.