Surgical treatment of bronchial stenosis with bronchoscopic dilatation and laser surgery in Catholic Clinic Koblenz-Montabaur

About the department

The Department of Pulmonology at the Catholic Clinic Koblenz-Montabaur offers the widest possible options for the diagnostics and treatment of benign and malignant diseases of the lungs, respiratory tract, and pleural cavities. The department has a specialized center for treating patients with lung cancer that is certified by the German Cancer Society (DKG). A lung cancer treatment regimen is developed for each patient on an individual basis within the interdisciplinary tumor board. The medical facility has unique clinical experience in providing medical care to patients with rare pulmonary diseases. The department's patients are diagnosed in modern diagnostic rooms, including the Pulmonary Function Laboratory, in which more than 10,000 examinations are carried out annually, ultrasound diagnostic rooms, etc. The department's team of pulmonologists cooperates closely with specialists in thoracic surgery and interventional radiology. The department has 50 beds for patient hospitalization. More than 2,300 inpatients are treated annually in the department, and about 1,500 patients receive outpatient care. The department is headed by Dr. med. Jutta Kappes.

The department admits patients with all lung and respiratory diseases, including lung cancer, bronchial asthma, chronic obstructive pulmonary disease, pulmonary emphysema, pneumothorax, interstitial lung diseases, sarcoidosis, cystic fibrosis, pneumonia, tuberculosis, and other pathologies. The doctors at the medical facility also achieve successful results in the treatment of rare pulmonary diseases. Upon admission to the department, a patient will have to undergo comprehensive diagnostics, which may include laboratory tests, instrumental examinations (X-ray, fluorography, or ultrasound scanning), imaging tests (CT and MRI), pulmonary function tests (body plethysmography, spirometry, or lung diffusion capacity measurement), and endoscopic diagnostic procedures (bronchoscopy, endobronchial sonography, or bronchoalveolar lavage). Based on the diagnostic data obtained, an optimal treatment regimen is developed, taking into account the patient's individual needs and wishes. Whenever possible, the department's specialists strive to use only conservative treatment with pills, infusion therapy, injections, physiotherapy procedures, etc.

The department is proud of its advanced endoscopic rooms, where patients are provided not only with diagnostic services but also effective therapeutic procedures that can often replace traumatic surgical interventions. For example, the department offers an innovative endoscopic treatment method for severe forms of emphysema and chronic obstructive pulmonary disease called endobronchial valve implantation. Patients with these pathologies suffer from shortness of breath, accompanied by severe difficulty breathing. The implantation of endobronchial valves allows for the elimination of the accumulation of excess air in the dilated alveoli, thereby helping to relieve shortness of breath and facilitate breathing. The essence of the procedure is the implantation of special valves in the lobe of the lung most affected by the pathological process. The therapeutic effect is achieved due to the fact that when exhaling, the implanted valves open, thereby ensuring the release of excess air from the alveoli of the affected lobe of the lung, and when inhaling, they close, preventing the flow of air to the pathologically altered areas of the lung. As a result, lung volume is reduced, making it easier for the patient to breathe. This endoscopic procedure was approved for use in clinical practice in 2018. It is considered innovative and is available only in advanced medical centers. The department also performs endobronchial coil implantation. The principle of operation of this method is identical to that of endobronchial valves, but this variant of endoscopic lung volume reduction is the most advanced.

In the field of endoscopic treatment, the department also widely uses argon plasma coagulation. This technique allows doctors to eliminate pulmonary hemorrhage, small neoplasms, pulmonary fibrosis, and other pathological changes in lung tissues. The basis of argon plasma coagulation is the action of a radio wave enhanced by argon (an inert gas). Due to the properties of argon, a high-frequency current can enter tissues without direct contact with them, as a result of which a so-called argon plasma torch is formed between the electrode and the tissue. With the help of a thin loop, the affected tissue is heated and excised. The main advantage of this treatment method is the elimination of the need to excise the tissue using surgical techniques. In addition, during argon plasma coagulation, a doctor has the ability to control the depth of plasma penetration so that healthy adjacent tissues can remain intact. The therapeutic procedure is therefore not only highly effective but also safe for the patient.

The department's medical team cooperates closely with thoracic surgeons, interventional radiologists, cardiologists, oncologists, radiation therapists, and other specialists. Thanks to the coordinated work of various doctors from related disciplines, the patient is guaranteed excellent medical care focused on long-term results. At the same time, the department's doctors always strive to surround the patient with care, show understanding and a humane attitude towards their health problem, and provide moral support during the entire therapeutic process.

The department's main clinical activities include:

• Diagnostic services
  • Laboratory tests
  • Instrumental examinations
    • X-ray scans
    • Fluorography
    • Ultrasound scans
  • Imaging tests
    • Computed tomography
    • Magnetic resonance imaging
  • Pulmonary function tests
    • Body plethysmography
    • Spirometry
    • Lung diffusion capacity measurement
    • Spiroergometry
    • Determination of the degree of lung compliance
    • Assessment of the respiratory muscle strength
    • Blood gas analysis during exercise and at rest
    • Non-specific and specific provocation tests
    • Rhinomanometry
  • Endoscopic examinations
    • Flexible and rigid bronchoscopy
    • Transesophageal sonography
    • Endobronchial sonography
    • Thoracoscopy
    • Bronchoalveolar lavage for diagnostic purposes
    • Pleural puncture for diagnostic purposes
    • Transbronchial lung cryobiopsy
• Therapeutic services
  • Drug therapy with pills, infusion therapy, and injections
  • Special physiotherapy for patients with respiratory diseases
  • Endoscopic therapeutic procedures
    • Endobronchial valve implantation
    • Endobronchial coil implantation
    • Argon plasma coagulation
    • Thoracoscopic talc powder spraying
    • Bronchoalveolar lavage for therapeutic purposes
    • Pleural puncture for therapeutic purposes
• Other medical services