Services

Full Overview of Services Provided by Me.

WHY SHOULD YOU CHOOSE MY SERVICES

GUARANTEED PROFESSIONALISM

Long term experience in field of respiratory medicine.
25 years experience in bronchoscopy and interventional pulmonology.
10 years experience in clinical trials as subinvestigator and principal investigator. Participation in international congresses as a speaker.

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GREAT CONNECTIONS

Close ties with top professionals in the advanced clinics world wide. Which gives a possibility of consultation and, if needed, sending patients directly there.

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NO COMPETITION

Only specialist in Georgia with experience in advanced bronchoscopic methods such an endobronchial biopsy, airway stenting, laser resection, valvular bronchoblocation.

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CONVENIENCE

In the National Center for Tuberculosis and Lung Diseases the largest flow of outpatients and hospital admissions with pulmonary diseases and for this reason the best infrastructure, high quality equipment and most experienced professionals.
Aversi clinic has good location, easy to access, the best coverage area in Georgia and Caucasus region, newest radiological and endoscopic equipment.

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I AM DOING WHAT IS DONE IN LEADING CLINICS AROUND THE WORLD.

My main goal is to help patients with serious lung problems to gain access to modern diagnostic and therapeutic methods currently available only in the advanced clinics of developed countries.

BRONCHO FIBROSCOPY (BF)Most commonly performed procedure in pulmonary medicine.
RIGID BRONCHOSCOPY (RB)Allows performing modern therapeutic methods.
ENDOBRONCHIAL BIOPSY (EB) Only diagnostic method for obtaining tissue from the endobronchial tumours in cases of suspected lung cancer.
AIRWAY STENTING (AS) Main indication to relief of symptoms consistent with airway obstruction.
LASER RESECTION (LR) Endobronchial treatment for interventional pulmonology.
VALVE BRONCHOBLOCATION (VB) Promising new approach for both acute and chronic conditions of the lung.

COMPLETE LIST OF SERVICES

LUNG DIAGNOSTICS

BronchoAlveolar Lavage (BAL)

Diagnostic procedure where lavage fluid is introduced to the terminal bronchioles and then recollected for analysis to examine cells, inhaled particles, infectious organisms or fluid constituents. This mildly invasive procedure should be performed prior to biopsy or brushing procedures. BAL aims to establish a diagnosis, to find out if infections and malignancies are present and to estimate the degree of disease activity e.g. in case of interstitial lung disease. To ensure that sufficient aspirate is available for analysis, the successive instillation of lavage fluid (100 – 300 ml for adults) into the target area is necessary.

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Chest X-Ray (CXR)

First mandatory examination of lungs. Because CXR is fast and easy, it is particularly useful in emergency diagnosis and treatment. It is very important to make a high quality CXR for next optimal diagnostic and therapeutic steps.

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Endobronchial Biopsy (EB)

Only diagnostic method for obtaining tissue from the endobronchial tumors in cases of suspected lung cancer. Without histo-morphological verification it is impossible to conduct chemotherapy treatment to patients with lung cancer. Commonly Endobronchial biopsy performed under the local anesthesia using biopsy forceps, brushes, fine needles for transbronchial fine needle aspiration (TFNA). It is non-invasive, brief, but very informative procedure that verifies the type of cancer and allows the oncologist to carry out the optimal treatment of chemotherapy.

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High Resolution Computed Tomography (CT)

Computed tomography (CT) of the chest uses special x-ray equipment to examine abnormalities found in other imaging tests and to help diagnose the cause of unexplained cough, shortness of breath, chest pain, or fever. CT scanning is fast, painless, noninvasive and accurate. Because it is able to detect very small nodules in the lung, chest CT is especially effective for diagnosing lung cancer at its earliest, most curable stage.

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Spirometry

Common office test used to assess how well your lungs work by measuring how much air you inhale, how much you exhale and how quickly you exhale. Spirometry is used to diagnose asthma, chronic obstructive pulmonary disease (COPD) and other conditions that affect breathing.

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Sputum Sampling

Helps clinicians diagnose things like pneumonia, bronchitis, and TB. the specimen must be of sufficient quantity. You need at least 15 ml to identify the offending organism. For some patients, such as those suspected of having TB, it may be necessary to obtain as many as three sputum specimens before the pathogen can be determined and the appropriate treatment begun. Bacterial sputum cultures detect the presence of disease-causing bacteria (pathogens) in people who are suspected of having bacterial pneumonia or other lower respiratory tract infections. Bacteria in the sample are identified and susceptibility testing is performed to guide antibiotic treatment.

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Trans Bronchial Needle Aspiration (TBNA)

Used for diagnosis and staging of bronchial diseases, including mediastinal or peripheral pathologies, subcarinal and parabronchial nodes and parenchymal abnormalities. It has been established as a minimally invasive, safe and cost-effective bronchoscopic technique. The standard TBNA technique uses 21-gauge cytology needles or 19-gauge histology needles together with a flexible bronchovideoscope. To localise the mass or node to be aspirated the bronchoscopist uses chest radiographs and CT scan. The needle is then advanced to the sampling area and moved out of the sheath. The target tissue is pierced with the needle and aspiration is started. After aspiration, the needle is fully retracted into the sheath and withdrawn through the working channel. TBNA is also a useful technique to diagnose lymphatic diseases e.g. lymphoma or adenopathy. For enlarged lymph nodes it might be required to obtain a biopsy to identify what exactly caused the enlargement of the lymph node. Therefore a sample is taken during a brief procedure and then pathologically examined for a final diagnosis. Another opportunity that TBNA provides the diagnosis of pulmonary and mediastinal lesions (particularly lung cancer) in a minimally invasive fashion. It can help determine the type of the tumour and whether an abnormality seen on a chest X-ray or CT scan is malignant or benign.

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Ultrasonography (USG)

Ultrasound has been proved to be valuable for the evaluation of a wide variety of chest diseases, particularly when the pleural cavity is involved. Chest ultrasound can supplement other imaging modalities of the chest and guides a variety of diagnostic and therapeutic procedures. Pleural effusion, pleural thickening, pleural tumors, tumor extension into the pleura and even the chest wall, pleuritis, and pneumothorax can be detected easily and accurately with chest ultrasound. Many ultrasound features and signs of these diseases have been well characterized and widely applied in clinical practice. Under real-time ultrasound guidance the success rates of invasive procedures on pleural diseases increase significantly whereas the risks are greatly reduced. The advantages of low-cost, bedside availability and no radiation exposure have made ultrasound an indispensable diagnostic tool in modern pulmonary medicine.

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LUNG TRATMENT

Airway Stenting (AS)

Main indication to relief of symptoms consistent with airway obstruction from either a malignant or benign obstruction that has failed other medical, surgical, or endoscopic therapies. In malignancy, stents provide excellent sustainable palliation for progressive symptoms in patients whose conditions have been considered terminal. Stent insertion can be an emergent life-saving procedure allowing relief of acute respiratory distress from airway obstruction. It can allow withdrawal from the mechanical ventilator in patients who could not otherwise be extubated.

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Breathing Exercises

Can make lungs more efficient Like aerobic exercise improves heart function and strengthens muscles. Breathing exercises helps to strengthen breathing muscles, get more oxygen, and breathe with less effort. Exercise can improve how well body uses oxygen, decrease symptoms and improve breathing, strengthen heart, lower blood pressure, and improve circulation, improve energy, making it possible to stay more active, improve sleep and make feel more relaxed, enhance mental and emotional outlook.

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Chest Massage Therapy

Plays an important role in training the body how to relax and help improve breathing. Respiratory issues, such as allergies, sinus problems, asthma and bronchitis, are one group of conditions that can benefit from massage therapy. In fact, the positive impact massage can have on respiratory function has been shown through research. Many muscles in the front and back of the upper body are accessory respiratory muscles. Massage techniques to lengthen and relax these muscles improve breathing capacity and function.

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Inhalation Therapy

Group of respiratory, or breathing, treatments designed to help restore or improve breathing function in patients with a variety of diseases, conditions, or injuries. The treatments range from at-home oxygen therapy for patients with chronic obstructive pulmonary disease to mechanical ventilation for patients with acute respiratory failure. Inhalation therapies usually include the following categories: oxygen therapy, incentive spirometry, continuous positive airway pressure (CPAP), oxygen chamber therapy, mechanical ventilation. Nebulizer therapy is an effective and efficient way to deliver medications directly into the lungs by inhalation for the patients with conditions such as asthma, pneumonia, cystic fibrosis and chronic obstructive pulmonary disease (COPD), bronchiectasis.

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Laser Resection (LR)

Most commonly recognized endobronchial treatment that the interventional pulmonologist uses today. It is used extensively for the palliation of symptoms of airway obstruction secondary to malignancies, and it provides effective therapy for benign airway lesions and stenosis. In selected patients, laser therapy has been shown to improve quality of life and functional status, and, in some cases, to extend survival. Palliation of symptoms from malignant airway obstruction is the most common indication for endobronchial laser therapy. Bronchoscopic laser therapy is a relatively safe procedure.

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Low Frequency Laser Therapy (LFLT)

Refers to the physiotherapy section, namely phototherapy. LFLT increases the permeability of the vessel walls in the irradiated region, slowing down the inflammation and preventing edema and hyperemia. Improves blood circulation irradiated area, thus accelerating the healing process and increases immunity. In pulmonology LFLT is successfully used to treat acute and chronic endobronchitis, erosive and ulcerative lesions of the bronchial wall, bronchiectasis, purulent inflammations.

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Sanitation (Lavage) Bronchoscopy (SB)

Applies in acute and chronic bronchopulmonary diseases, such as purulent endobronchitis, bronchiectasis, COPD, prolonged mechanically ventilated conditions. SB begin with the removal of the contents of the tracheobronchial tree using suction. After that most affected bronchi are washed using antiseptic solution. Simultaneously administered mixture with subsequent sanitizing which is aspirated by suction. Therapeutic bronchoscopy is completed by introduction mucolytics and / or antibiotics. After SB the patient feels much better, breathing normalizes, the amount of sputum decreases.

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Valvular Bronchoblocation (VB)

Promising new approach for both acute and chronic conditions of the lung and for treating diseased lung in emphysematous patients or damaged lung resulting in air leaks. The valve is a device placed in selected lung airways and limits the airflow to the occluded areas of the lung while still allowing mucus and trapped air to pass by outside of the valve in proximal direction. For the treatment of air leaks, the valve limits airflow to injured tissue. Prolonged post-surgery, persistent as well as spontaneous secondary air leaks have been treated successfully. Published case reports showed a 94% success rate of treatment of prolonged air leaks. For the treatment of emphysema, the valves allow total occlusion of single lobes with atelectasis.

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