New KGH procedure to reduce lung cancer distress

MR1169 Bronchoscope Dr George Tsaknis and Jayne Haycock SN 2.jpg

Kettering General Hospital has launched a new procedure to remove tumours from the bronchial tubes - providing quick relief for lung cancer patients without the need for a major operation.

It is first time the hospital has undertaken the procedure - which is usually done by a thoracic surgeon under a general anaesthetic at one of a handful of specialist respiratory centres.

It will mean patients do not have to travel so far for treatment and provide an alternative for individuals who are not suitable for major surgery.

The procedure is called electrosurgical bronchoscopic tumour debulking and uses an electrified loop of wire – which lies inside a bronchoscope tube camera– to cut into and remove the tumour piece by piece.

Consultant in Respiratory Medicine, Dr George Tsaknis, with the assistance of Endoscopy Staff Nurse, Jayne Haycock, performed the procedure on an elderly man on November 18.

Dr Tsaknis said: “The use of electrocautery for partial or complete removal of endobronchial tumours is an advanced bronchoscopic technique

“Only a handful of Respiratory Centres in the UK provide this procedure in their respective endoscopy lists under sedation, and Kettering General Hospital is now one of them.

“The procedure is unusual. It involves the use of a high energy electric current with various instruments inserted into the patient’s bronchial tubes though a flexible bronchoscope.

“The equipment is used to cut out and remove a major part, or even the whole of, an obstructive tumour from the patient’s airways.

“Most commonly, this procedure normally happens under general anaesthetic by a Thoracic Surgeon, but many patients are not medically well enough for a general anaesthetic.

“This new procedure offers an alternative because it enables patients to be sedated – but remain conscious– during the procedure, which lasts from 30-60 minutes depending on the complexity of the case.

The only other alternative at the moment is a major operation in a specialist hospital – the nearest of which for our patients is Glenfield Hospital in Leicester.”

The first patient to have the procedure was very unwell with a large tumour obstructing his main bronchial tube, causing shortness of breath and excessive ‘wheezing’.

His general status would not allow a general anaesthetic and surgery but he agreed to have the new procedure.

Dr Tsaknis said: “The procedure went very well reducing the patients’ breathlessness and stopping the ‘wheezing’.

“The gentleman had no complications and he was very pleased with the symptom relief.

“We are delighted that we can now offer this ‘cutting edge’ service to our patients without having to refer them to Thoracic Surgery, avoiding waiting lists and major operations.”

The new procedure will mean symptom relief for at least 20 patients per year who would not be suitable for other alternative operations.

It is not the first time Kettering General Hospital’s respiratory consultants have developed innovative new services for local patients.

In February 2013 they launched an innovative Thoracoscopy Service using a special tube and camera to remove fluid accumulation in the chest. This reduced the need for hospital visits for some patients from three down to one and reduced the need for some patients to travel to specialist hospitals outside of the area.

In 2016 the team’s Ambulatory Pneumothorax Service - run by consultants in respiratory medicine, Dr Raja Reddy, and Dr Muhammad Naeem – was shortlisted in the Innovation Team category of the BMJ Awards. This was a one-stop service for lung cancer patients which reduced hospital stays by 57%.

In February 2019 the team further expanded its pioneering Thoracoscopy Service by buying £24,000 of additional equipment which they won in an internal Dragon’s Den-style competition held for staff in October 2018.

In June 2019 a new endobronchial ultrasound bronchoscopy service was launched which enables biopsies of the lymph nodes inside the chest without the need for major surgery.