Interventional Pulmonology · Hyderabad
What Is an Interventional Pulmonologist: When Do You Need One?
By Dr. Kunal Waghray, MD DM DNB MNAMS EDRM, Interventional Pulmonologist, Respire Airway Clinics, Hyderabad. Last reviewed: 12 May 2026.
If your doctor has referred you to an "interventional pulmonologist," you are in good company. Most patients have never heard the term before their first referral. An interventional pulmonologist is a lung specialist with advanced training in procedures including bronchoscopy, EBUS, cryobiopsy, airway stenting, and pleural drainage, that go beyond what a general pulmonologist performs.
This page explains what the subspecialty involves, what an IP specialist can do for you, and what to expect when you arrive for your first appointment.
"In my practice at Respire Airway Clinics, the most common question I hear at a first consultation is: 'Why was I referred to you instead of my regular chest doctor?' The answer is almost always a procedure."Dr. Kunal WaghrayMD DM DNB MNAMS EDRM, Interventional Pulmonologist
What Is Interventional Pulmonology?
Think of it this way. A general cardiologist manages heart conditions with medication and monitoring. An interventional cardiologist does the procedures: the stents, the angioplasties, the catheter work. Interventional pulmonology works the same way, applied to the lungs.
An interventional pulmonologist focuses on procedures that diagnose or treat diseases of the airways, the lung tissue itself, and the pleura (the lining around the lungs). The tools are different from surgery. Most are passed through the mouth or a small puncture, not through an open incision.
How is IP different from regular pulmonology?
A general pulmonologist treats respiratory illness with medication, inhalers, oxygen, and follow-up. An interventional pulmonologist steps in when a procedure is needed to make a diagnosis or to physically treat a problem in the airway or pleural space. Most patients who see an IP specialist were first evaluated by a general chest physician.
The training is also longer. After standard pulmonary medicine training, an interventional pulmonologist completes additional fellowship work focused entirely on procedures.
When did interventional pulmonology develop as a specialty?
Interventional pulmonology emerged as a distinct subspecialty in the late 1990s and 2000s, as bronchoscopic and pleural techniques grew more sophisticated. In the United States, the ACGME formally recognised it as a fellowship discipline. In India, the Indian Association for Bronchology (IAB) is the professional body that supports training and standards in the field.
What Does an Interventional Pulmonologist Do?
IP specialists perform minimally invasive procedures that diagnose and treat diseases of the airways, lungs, and pleura, without open chest surgery. Most procedures are done through a flexible scope or a small needle puncture, with the patient under sedation or local anaesthesia.
Bronchoscopy
A flexible camera passed into the airways through the mouth or nose to inspect, sample, or treat. This is the foundational IP procedure.
EBUS (Endobronchial Ultrasound)
A type of bronchoscopy that uses ultrasound to guide a needle into lymph nodes near the lung. Used for lung cancer staging and TB diagnosis.
Cryobiopsy
A lung biopsy performed through a bronchoscope using a freezing probe. Avoids open chest surgery for many interstitial lung disease patients.
Thoracentesis
Needle drainage of fluid from around the lungs, used for pleural effusion.
Pleural Procedures
Including thoracoscopy (camera inspection of the pleural space) and pleurodesis (sealing the pleural space to stop recurrent fluid build-up).
Airway Stenting
Placing a stent to keep an obstructed airway open, used in tumour-related narrowing or post-inflammatory scarring.
Are IP procedures safe?
IP procedures are minimally invasive and have a strong safety record when performed by trained specialists in equipped centres. The most common procedure, flexible bronchoscopy, has a serious complication rate well under 1 percent in published literature. That said, every procedure carries some risk. The right question is not "is it safe in general?" but "is it the right procedure for me, performed by a team that does it regularly?"
Do IP procedures require general anaesthesia?
Most IP procedures are done under conscious sedation, not general anaesthesia. You stay breathing on your own, you are comfortable, and you usually go home the same day. A few procedures, like rigid bronchoscopy or complex airway stenting, do require general anaesthesia. Your consent form and pre-procedure briefing will specify which applies in your case.
Interventional Pulmonologist vs. General Pulmonologist: What's the Difference?
A general pulmonologist diagnoses and manages respiratory diseases like asthma, COPD, TB, and sleep apnea. An interventional pulmonologist performs the procedures that investigate or treat when diagnosis or treatment requires going beyond a prescription.
| General Pulmonologist | Interventional Pulmonologist |
|---|---|
| Manages asthma, COPD, TB, sleep apnea with medication | Performs bronchoscopy, EBUS, cryobiopsy, pleural procedures |
| First point of contact for cough, breathlessness, wheezing | Receives referrals when a procedure or tissue diagnosis is needed |
| Orders chest CT, PFT, and basic investigations | Performs the biopsy or drainage that gives a definite answer |
| Provides long-term follow-up and prescriptions | Performs the procedure, reports findings, returns the patient to ongoing care |
| Standard pulmonary medicine training | Pulmonary medicine training plus interventional fellowship |
Can a general pulmonologist do bronchoscopy?
Yes, many general pulmonologists are trained in basic flexible bronchoscopy. The distinction is in the advanced procedures: EBUS, cryobiopsy, thoracoscopy, stenting, and complex airway work. These require dedicated fellowship training and regular case volume.
Do I need to see both specialists?
Often, yes. A typical path looks like this: your general pulmonologist (or family doctor) identifies a problem that needs a procedure. You are referred to an IP specialist for that procedure. After the procedure and the report, you usually return to your original doctor for ongoing care, unless the IP specialist is also managing the condition.
When Do You Need an Interventional Pulmonologist?
Here are the situations where an interventional pulmonologist adds something that general pulmonology or radiology alone cannot provide.
In India, referrals to interventional pulmonology often come from oncologists, rheumatologists managing connective tissue disease, general physicians, and family doctors who have ordered a chest CT and found something that needs sampling. If your situation matches one of the lines above, you are likely a candidate for an IP consultation.
What to Expect at Your First Consultation at Respire
Your first appointment with Dr. Kunal Waghray is a consultation. No procedure is performed on the first visit without your informed consent and preparation.
What to bring
- All chest CT scans on disc, plus the radiologist's report
- Pulmonary function test (PFT) reports, if any
- Recent blood test results
- The referral letter or prescription from your doctor
- A current list of medications, including blood thinners
If you do not have all of this, come anyway. We can order what is missing. But scans on disc are worth the extra effort to bring; they are far more useful than printed images.
What questions to expect
Dr. Waghray will ask about your symptoms, when they started, and how they have changed. He will ask about your scan history, any prior procedures, your medications, and any allergies. He will also ask about smoking history, TB exposure, occupational exposures (relevant for ILD), and family history where applicable. The consultation usually runs 20 to 30 minutes. You will leave with a clear plan.
How quickly will a procedure be scheduled?
This depends on urgency. Suspected lung cancer cases and symptomatic airway obstruction are scheduled within days. Most elective procedures are scheduled within one to two weeks of the consultation decision. If you would prefer to consult an interventional pulmonologist in Hyderabad for a procedure that has already been recommended elsewhere, second opinions are welcome.
Frequently Asked Questions
Is interventional pulmonology a form of surgery?
No. Interventional pulmonology uses minimally invasive techniques, mostly through a flexible scope or a small needle, to do what would once have required open chest surgery. There is no incision in most cases, and patients typically go home the same day.
Who refers patients to an interventional pulmonologist?
In India, common referral sources are general pulmonologists, oncologists, rheumatologists, general physicians, and family doctors. Most referrals are triggered by an abnormal chest CT, an unexplained pleural effusion, or a suspected lung cancer that needs tissue diagnosis and staging.
Is interventional pulmonology available in Hyderabad?
Yes. Respire Airway Clinics offers a dedicated interventional pulmonology practice in Hyderabad, with consulting locations at Basheer Bagh and Jubilee Hills. Procedures are performed at partner hospitals with full equipment for bronchoscopy, EBUS, cryobiopsy, and pleural work.
What qualifications does an interventional pulmonologist have?
A qualified interventional pulmonologist in India typically holds an MD or DNB in respiratory medicine, followed by DM (Pulmonary Medicine) or equivalent, plus dedicated fellowship training in interventional pulmonology. Dr. Kunal Waghray holds MD, DM, DNB, MNAMS, and EDRM (European Diploma in Respiratory Medicine), with fellowship training in interventional pulmonology at Amrita Institute.
Ready to Book a Consultation?
Now that you know what interventional pulmonology involves, you can make sense of your referral and what the next steps look like. If you have been referred, or if your situation matches one of the indications above, Dr. Kunal Waghray at Respire Airway Clinics accepts direct consultations.