Workshop Descriptions

Asthma

Objectives of Case-Based Discussions with Mentors
• Place of Bronchial Thermoplasty in the era of biologic therapies
• Quality of life versus lung function for Rx decision making
Lifelong injections versus a one-off Rx w BT
Upfront risks of each of the new therapies
• Decision points- recurrent symptoms after Bronchial Thermoplasty, recurrent symptoms after Biologic Therapies

Hands-on training – supervised teaching on models with real instruments
• Bronchial Thermoplasty
• Impulse Oscillometry

Developing Interpretive skills
• Eosinophil counts on steroids
• Borderline IgE

TSANZ Faculty will include
Dr David Langton
Prof Frank Thien
For a full list of Local and International faculty, refer to our Discussants page here.


EBUS TBNA

Objectives of Case-Based Discussions with Mentors
• Use of ROSE
• Linear EBUS to diagnose & stage in the one procedure
• IHC to differentiate lung primary from other tumours
• PD-L1 staining of TBNA specimens
• Molecular testing of TBNA specimens
• Use of TBNA in lieu of peripheral nodule biopsy
• Clinical and Pathologic staging
• Plan to obtain tissue for diagnosis staging and molecular testing
• Process for managing tissue sample to ensure accurate diagnosis to allow treatment plan
• Proposed treatment based on clinical radiologic and molecular analysis
• Duties of each member of multidisciplinary team

Hands-on training – supervised teaching on models with real instruments
• EBUS TBNA
• EUS B
• Making smears

Developing Interpretive skills
• Smear assessment
• Key landmarks in EBUS and EUS B

Faculty will include
Assoc Prof Kazuhiro Yasufuku
Dr Bin Hwangbo
Dr Dan Steinfort
Dr Scott Twaddell
For a full list of Local and International faculty, refer to our Discussants page here.


Interstitial Lung Disease

Objectives of Case-Based Discussions with Mentors
• Cryo versus VATS biopsy
• Rationale for biopsy with common radiologic patterns of ILD
• Time points of RFTs over time- early / middle / too late in time course of illness
• Side effects of Rx -what now
• Timing of transplant
• Managing an acute flare

Hands-on training – supervised teaching on models with real instruments
• Cryobiopsy
• The role and placement of balloons
• Different intubation techniques- ET tubes, rigid bronchoscopy

Developing Interpretive skills
• Image/investigation interpretation
• CT – is it IPF / NSIP
• Biopsy interpretation- the key pathognomonic histologic features

Faculty will include
Dr Jurgen Hetzel
Prof Alvin Ing
Dr Lauren Troy
For a full list of Local and International faculty, refer to our Discussants page here.


Large Airway Pathology

Objectives of Case-Based Discussions with Mentors
• Complex carinal lesions – Discussion of local therapy options. To stent or not to stent. Progression after initial local control, disease progression complications of stenting can be discussed e.g. development of trachea-oesophageal fistula; granulation tissue etc.
• Tracheobronchomalacia – Typical symptoms Diagnostic techniques for TBM – CT criteria and examples; bronchoscopic assessment. Classification of TBM/EDAC. Therapeutic options.

Hands-on training – supervised teaching on models with real instruments
Rigid bronchoscope insertion
• 3 identical sub-stations (rigid scope/telescope/camera/manakins)
• Removal of central airway mass/recanalization of airway
• Foreign body removal using basket device (bronchoscope and stack)
• Cryoresection and cryoablation (material such as a grape in see-through plastic tube, bronchoscope and stack)
• Balloon dilatation (bronchoscope desirable but not essential) –

Stent deployment
a. Metallic straight
b. Polyflex
c. Microtech Y-stent
d. Dumon silicone stent

Developing Interpretive skills
1. Video clips of debulking techniques APC, laser, snares, cryoresection, balloon dilatation
a. Briefcase vignettes where these would be indicated e.g. visible tumour obstruction; pedunculated polyp.
b. Descriptions of techniques, precautions, indications, complications

2. Examples of endobronchial obstruction/tumour Classification of airway stenosis by Freitag. Learn how to describe lesions to foster communication with other colleagues.

3. Multimedia demonstration of stent insertion case – lesion requiring a stent for management of obstruction: planning and preparation of the case : consent, equipment, emergency box preparation. Options for different types of stent. Video of stent deployment procedure.

Faculty will include
Dr Peter Wu
Dr Jonathon Williamson
Dr Tajalli Saghaie
For a full list of Local and International faculty, refer to our Discussants page here.


Pulmonary Nodule

Objectives of Case-Based Discussions with Mentors
• How to access the lesion and options to do so. If biopsy: CT guided biopsy or bronchoscope with radial
• If bronchoscope: Cryo or Radial forceps or Radial brush or needle biopsy
• Consider sampling to account for the two questions of malignancy vs infection.
• What concerns one might have when sampling a cavity.
• CT interpretation (“Kurimoto mapping” technique)
• Role of cryo biopsy in nodules with eccentric ebus appearance

Hands-on training – supervised teaching on models with real instruments
• EBUS Guide sheath
• Virtual bronchoscopy modules
• Archimedes planning and sampling

Developing Interpretive skills
CT assessment

Faculty will include
Prof Noriaki Kurimoto
Prof Felix Herth
Dr Fumihiro Asano
Dr Phan Nguyen
Dr Samantha Herath
For a full list of Local and International faculty, refer to our Discussants page here.


Paediatrics

Objectives of Case-Based Discussions with Mentors
• Vascular Ring (Double aortic arch): intraoperative and post-operative bronchoscopy
• H shaped Traceo-esophageal fistula: Diagnosis and cannulation
• Missed Foreign body, its long-term complications and removal
• Airway hemangioma with discussion around what constitutes atypical croup and recurrent croup.

Hands-on training – supervised teaching on models with real instruments
• Foreign Body retrieval
• Difficult intubation

Developing Interpretive skills
CT assessment of complex congenital airway and vascular anomalies

Faculty will include
Dr Nitin Kapur
Dr Brent Masters
For a full list of Local and International faculty, refer to our Discussants page here.


Pleural Procedures

Objectives of Case-Based Discussions with Mentors
• Lytic therapy – timing
• Lytic therapy choices
• Lytics in malignancy
• Blunt dissection versus seldinger
• Tunnelled pleural catheter versus Talc slurry versus VATS versus Pleuroscopy
• Removal of IPC timing
• Frequency of IPC drainage

Hands-on training – supervised teaching on models with real instruments
• Seldinger
• Blunt dissection
• Tunnelled pleural catheter

Developing Interpretive skills
• Lights criteria
• CT
• PET in pleural disease

Faculty will include
Dr YC Gary Lee
Dr Rajesh Thomas
For a full list of Local and International faculty, refer to our Discussants page here.


Step by Step Bronchoscopy Training

Hands-on training – supervised teaching on models with real instruments
• Building Step by step exercises into performing bronchoscopy
• Mentoring on posture, handling,
• Improving skills for easier bronchoscopy
• CT interpretation

Developing Interpretive skills
• Common and uncommon airway pathologies

Faculty will include
Prof Henri Colt
Prof Eric Edell
Dr Elaine Yap
Dr Sylvia Quadrelli
For a full list of Local and International faculty, refer to our Discussants page here.


Ultrasound - Lung and Pleural

Objectives of Case-Based Discussions with Mentors
• Differentiate localised consolidation from a loculated effusion with internal structures
• Identify the cause of acute respiratory failure based on the presence or absence of Comets, Consolidation, Central venous pressure, Pleural effusion or zero findings. C3PO protocol-
• When to tap a ‘heart failure’ patient
• Sonographic significance of simple effusion- transudate or exudate
• Sonographic features of complex effusion and its significance always exudate
• How does ultrasound guide treatment? How is effusion size measured and followed?
• How Ultrasound can assist with estimation of the JVP, and detection of B lines in heart failure and consolidation in pneumonia.
• Real-time versus x marks the spot for guiding thoracentesis and chest tube insertion
• Real-time to control needle position in chest wall relative to intercostal vessels

Hands-on training – supervised teaching on models with real instruments
• Different probes and ultrasound hardware

Developing Interpretive skills
• Interpret all of the above appearances

Faculty will include
Dr Mark Hew
Dr Luke Garske
For a full list of Local and International faculty, refer to our Discussants page here.

Ultrasound Stream sponsored by:


Valve Placement

Objectives of Case-Based Discussions with Mentors
• Assessing candidates for BLVR physiologic and radiologic parameters
• Different 6-minute walk results/lung volume results – do valve or not
• Comorbidities – pulm HT, IHD, mobility impairments / sputum / bronchiectasis / EDAC / OSAS
• Which lobe should be targeted and with what device/technique?
• Cause(s) of only partial atelectasis of lobes after BLVR and what should be done to address this/these?
• Management of air leaks

Hands-on training – supervised teaching on models with real instruments
• Strat X
• Chartis
• Valve insertion

Developing Interpretive skills
• CT assessment
• VQ scan assessment

Faculty will include
Dr Matt Salamonsen
Dr Farzad Bashirzadeh
For a full list of Local and International faculty, refer to our Discussants page here.


Multidisciplinary Case Discussions

Multidisciplinary case discussions regarding history, clinical, radiologic and management aspects of two clinical cases: "Mesothelioma" and "Tuberculosis".

This session will have inputs from:
• Pathology
• Radiology
• Interventional Pulmonology
• Surgery
• Medicolegal aspects

The session will be chaired by Prof Henri Colt and Dr Silvia Quadrelli.


TSANZ Advanced Trainees Training Orientation

TSANZ trainees will have an update from STC Chair regarding updates on TSANZ training in general, and specifically as to how the APCB congress will contribute to aspects of the new guidelines on training for standard bronchoscopy, EBUS, and chest tube insertion.
Room: Arena 1A