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Interventional Pulmonologist Otis Rickman, D.O., recently came to Vanderbilt as director of Bronchoscopy. (photo by Susan Urmy)

Rickman comes to VUMC as director of Bronchoscopy

BY: DAGNY STUART

10/16/2009 - Otis Rickman, D.O., has joined Vanderbilt as an assistant professor of Medicine and Thoracic Surgery and director of Bronchoscopy.

Rickman is the first Interventional Pulmonologist to join VUMC and he will focus on patients with breathing issues, including lung cancer patients.

The Oklahoma native comes to Vanderbilt from the Mayo Clinic, where he was an assistant professor.

“Vanderbilt has an excellent reputation in lung cancer, especially with the Specialized Program of Research Excellence (SPORE) grant program supported by the National Cancer Institute,” said Rickman.

“I am excited to bring the specialty of Interventional Pulmonology to the Medical Center and Vanderbilt-Ingram Cancer Center because no one else is providing these services in this part of Tennessee.”

Interventional pulmonologists can treat all aspects of lung disease, from diagnosis at an early stage of disease through caring for people who are short of breath or suffering from advanced lung cancer.

These specialists use rigid or flexible bronchoscopes and miniaturized equipment inserted into the airway to search for cancer cells or blockages and treat the affected tissue.

“We will be looking for better ways to detect and treat lung cancer early in the disease process,” Rickman said.

“One technique involves autoflourescence bronchoscopy, a special type of bronchoscope with a specific wavelength of light. If you put a blue light into the airway, the tissue normally shines green, but if it is a reddish color, it could be cancer instead of normal mucosa.

“We insert a tiny ultrasound device to see if the cancer is still in the mucosa or if it has invaded deeper. If so, we can treat the area with procedures like electrocautery or laser therapy.”

Rickman also will provide relief for patients who are in great distress from advanced lung cancer or other pulmonary diseases.

“If the cancer has invaded the trachea, those patients often feel like someone is choking them,” Rickman explained.

“We can go in with a rigid bronchoscope and lasers to open the area, much like a plumber. We also insert stents to keep the airway open and improve the patient's breathing.”

These procedures are noninvasive and done on an outpatient basis, and they may spare patients from undergoing surgery.

For patients with pleural effusions, which are fluid collections around the lungs, Rickman uses ultrasound to identify the effusions and then drain them.

Catheters placed just under the skin allow patients to change the drainage ports at home.

Rickman said surgical patients who had endotracheal tubes inserted may develop inflammation of the windpipe.

Other inflammatory diseases like relapsing polychondritis and Wegener's granulomatosis also can cause obstruction of the windpipe.

“With very careful assessment, directed laser cuts, gentle dilations and sometimes stent placement, we can give people relief,” said Rickman.

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