UNLV Health and UMC Build the First Interventional Pulmonology Program in Nevada
UNLV Health and UMC Build the First Interventional Pulmonology Program in Nevada

UNLV Health’s Arthur Oliver Romero, MD, recently got an opportunity at UMC to use the advanced fellowship training in interventional pulmonology he received at the University of California San Francisco (UCSF). (UNLV Health is the new name of the multi-specialty group practice of the medical school – formerly known as UNLV Medicine.)

And he may well have saved a life.

Using the robotic-assisted ION platform designed by Intuitive Surgical that was recently acquired by University Medical Center (UMC) — the first and only hospital in the state with the groundbreaking program — Dr. Romero diagnosed a patient with early-stage lung cancer. Diagnostic tissue from the hard-to-reach lesion was collected through robotic bronchoscopy and this information was given to a surgeon. Less than two weeks later, the patient underwent surgery to remove the tumor.

“That patient’s lung cancer is now gone,” said Dr. Romero. “We got it out before there was any evidence of spread.”

The ION system provides new levels of precision, reach and stability when compared to manual biopsy techniques. The ION has an ultra-thin, easily controllable catheter that can bend 180 degrees in all directions.

Doctors can use the catheter to navigate through the lung to reach nodules in any airway segment. The robotic biopsy needle can also pass through very tight bends via the catheter to collect tissue in the peripheral lung, enabling a more precise biopsy and safer experience for patients.

Almost 1 in 4 cancer deaths are due to lung cancer, making it the leading cause of cancer death among both men and women.

Armed with better skills and broader experience dealing with the most complicated patients, Dr. Romero is now building the first interventional pulmonology (IP) program in Nevada. He is poised to help not only patients with lung cancer but other forms of advanced lung disease.

Angelica Honsberg, MD, the pulmonary critical care division chief for the Kirk Kerkorian School of Medicine who oversees the care of the sickest COVID-19 patients in UMC’s intensive care unit (ICU), says the new interventional pulmonology program at UMC will make a significant difference in lung disease care in Southern Nevada. She notes that Dr. Abhishek Kumar, another fellowship-trained interventional pulmonologist, recently joined the medical school and should prove to be a valuable addition to the new program.

“We’re taking a big step forward for the people of Nevada…People will be able to get world-class treatment right at home.”

“Historically,” she says, “there has been a gap in lung cancer care in our area, with many residents being diagnosed at an advanced stage of disease and not having consistent access to more advanced interventions. The new interventional pulmonology program, created through the joint efforts of the Kirk Kerkorian School of Medicine and UMC, offers Southern Nevada residents options for both lung cancer and severe emphysema treatment that they previously would have had to travel elsewhere to have. Our department is confident that being able to offer more options to Southern Nevadans will improve both quality of life and survival.”

Dr. Romero, who still must spend much of his time treating COVID-19 patients, is also performing tracheostomies to decrease patients’ time in the ICU. He is thankful for the partnership between UNLV Health and UMC. “Without UMC acquiring the most advanced equipment available, I would not be able to offer the best care to many of our lung cancer patients.”

Robotic bronchoscopy, which Dr. Romero uses for minimally invasive access to virtually any part of the lung, also allows for the delivery of dye markers to aid a surgeon on removing as little of the lung as possible. He’s also treating patients through rigid bronchoscopy, a therapeutic modality where a hollow metal tube is placed in the airway to facilitate the removal of airway tumors, relieve strictures and even placement of airway stents.

Soon, Dr. Romero says the new IP program will offer bronchoscopic lung volume reduction, which is for patients with severe emphysema. It involves the placement of valves in the airways with the purpose of collapsing the worst functioning lobe of the lung. This allows other healthier parts more room to expand with the goal of relieving the patient’s shortness of breath and exertional limitations.

In addition, Dr. Romero says other novel procedures being developed and soon to be offered are: medical pleuroscopy, where a camera is placed in the space between the lungs and the chest wall to evaluate and treat hard-to-diagnose cancer and infections; and lung cryobiopsy, where a catheter that can achieve extremely cold temperatures is used to freeze lung tissue that is extracted with the use of a bronchoscope. This allows for non-surgical biopsy of interstitial lung disease, which describes a large group of disorders, most of which cause progressive scarring of lung tissue.

“We’re taking a big step forward for the people of Nevada,” Dr. Romero says. “People will be able to get world-class treatment right at home.”

Photo: Dr. Arthur Romero, assistant professor of pulmonary and critical care medicine and UNLV Health physician, helps patients with advanced lung diseases through minimally invasive procedures. Courtesy of UNLV Health.

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