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Medical team

Interventional pulmonology procedures require the cooperation of two physicians, the anesthesiologist and the bronchoscopist. Both must be familiar with interventional techniques, and must learn to share the patient’s airway.

Laser applications in medicine are so novel that few criteria have been set in stone as to who is able to perform laser surgery. Some form of basic training however, is necessary. The latter should include at least a course in laser theory, safety, and its tissue effects, hands-on experience with animal models, and finally some form of supervised training at a specialized center.

The anesthesiologist does not require special training. Nonetheless a basic understanding of technical problems inherent to endoscopic resection should be sought. The anesthesiologist should witness a few procedures before attempting to assist alone, in order to become acquainted with assisted spontaneous ventilation techniques in endoscopy, its respiratory complications, and the nuances of adequate ventilation in a high-risk patient.

Endoscopic resection in the airway mandates close collaboration between the anesthesiologist and the endoscopist. Respect for and confidence in each other’s abilities is essential. Before anesthetizing a patient in respiratory distress, the anesthesiologist must be confident that the endoscopist will prioritize ventilation and will be able to maintain a patent airway throughout the procedure. The endoscopist in turn must be able to trust the anesthesiologist’s judgement and ability in maintaining an adequate level of anesthesia.

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