In this exclusive interview, we sit down with Professors Hervé and Guy Dutau, authors of “History and Rise of Pediatric Interventional Pulmonology,” the first article published in 2025 in the journal Pediatric Interventional Pulmonology. Together, they share their contributions to the field, talk about history, their motivations, experiences, and hopes for the future of pediatric interventional pulmonology.
Historical Perspective
PIPJ: Can you share what initially motivated you to specialize in pulmonology and particularly focus on pediatric interventional pulmonology?
Guy: I initially wanted to pursue pediatrics because my wife’s uncle was a pediatrician, and he greatly inspired me professionally. Once I became a pediatrician, I had to obtain a diploma in pulmonology so I wouldn’t have to rely on on adult pulmonologists, whose contributions were considered insufficient to address the specific issues of our young patients.
Hervé: When I was a child, I would watch my father in his office as he carefully examined pediatric chest X-rays. I found it very interesting, and I wanted to do the same when I grew up. Medicine has always been my calling, and pulmonology was a natural choice. My cousin, Alain Didier, was the head of the adult pulmonology department at the Toulouse University Hospital, and he was another role model for me.
PIPJ: What were the key challenges you faced in establishing the French experience with rigid bronchoscopy in the 1970s, and how did you overcome them?
Guy: Until the early 1970s, pediatrics was essentially the “general medicine” for infants and adolescents up to 15 years old, a limit that was later extended to 18 in many university hospitals (CHUs). When a pediatrician needed a consultation on a pulmonary case, they would seek the opinion of an adult pulmonologist. The same approach is applied in neurology and hematology. The results were variable and often disappointing. Furthermore, the equipment available to adult pulmonologists was rudimentary at best. I successfully performed the extraction of a bronchial foreign body (BFB) using a portable endoscope powered by a miraculous battery, which, of course, shut down at the end of the procedure. That portable endoscope could have easily been displayed in a museum.
1975 marked the opening of the second hospital/CHU in Toulouse (Rangueil CHU). Thanks to funding from various departments, I was fortunate enough to acquire the most advanced Storz endoscope, which was capable of taking photographs. All rigid bronchoscopies were performed under general anesthesia, always with the same anesthetist, Dr. Annie Sengelin. This partnership was undoubtedly key to our success. At that time, we learned about rigid bronchoscopy from several French pediatric pulmonologists, including Professors André Labbé (CHU Clermont-Ferrand), Marc Albertini (CHU Nice), and many others. The two main indications for this technique were foreign body removal and tuberculosis. Despite the advent of flexible bronchoscopes, rigid bronchoscopy remained the gold standard for safety reasons.
Technological Innovations
PIPJ: The introduction of video bronchoscopy and other advanced tools has transformed the field. Which innovation do you consider the most impactful, and why?
Hervé: For me, the greatest innovation in recent years is bronchial echoendoscopy, as it has allowed for the non-invasive diagnosis of mediastinal-hilar pathologies. It has now become essential.
Clinical Insights
PIPJ: The article mentions the diverse issues of foreign body extraction in children. Can you share a memorable case that highlighted the complexities of this procedure?
Guy: Every removal of a bronchial foreign body (BFB) is quite unique. It is impossible to select a specific case, as all extractions are challenging—especially when the foreign body is a metal ball, which cannot be gripped by standard metal forceps. We even attempted to use magnetic forceps in such cases.
One particularly surprising case was the extraction of a cotton swab, which had been thrown by the mother, picked up by the infant, and subsequently inhaled. The upper half of the cotton swab was lodged in the trachea, while the lower half was in the left main bronchus. The child was only moderately uncomfortable, but we knew the foreign body was present because the left lung was excluded on the technetium-99m scintigraphy! The extraction was straightforward, with a secure grip on the cotton tip, followed by the successful removal of the mass and the foreign body using the bronchoscope. The outcome was a considerable surprise, and the post-procedure recovery was uneventful.
Personal Contributions
PIPJ: Guy, Your work in training and equipping pediatric pulmonology departments has had a lasting impact. How can one ensure the next generation of specialists continues this legacy?
Guy: Learning how to remove a bronchial foreign body is a matter of teamwork. Despite extensive training, some novice practitioners may not yet have the necessary skills. It’s important to know how to guide them effectively! There are valuable learning opportunities with mannequins that can help build competence.
PIPJ: Hervé, what do you think? What is the role of adult interventional pulmonologists in helping the development of pediatric interventional pulmonology?
Hervé: I believe that bronchoscopic procedures, both in terms of volume and experience, are more prevalent in the adult population. In challenging therapeutic bronchoscopy cases, we can assist our pediatric colleagues, either by offering advice or by directly performing the procedures ourselves, as our equipment is more advanced.
Future Directions, Reflections, and Advice
PIPJ: What advice would you give young medical professionals interested in pursuing a career in pediatric interventional pulmonology?
Hervé & Guy: The most important thing for us is the passion for what we do; it is the foundation of any medical practice, which remains a vocation. The second key element is finding a capable mentor who is willing to share his knowledge. It is always helpful to visit expert centers in your country, and if none exist, then globally. This allows one to observe different practices and adapt them based on one’s professional environment, the needs of the population, and economic possibilities.
PIPJ: Hervé, as someone actively involved in the adult field today, how did you feel when you treated pediatric patients?
Hervé: I remember my first pediatric bronchoscopy. It was a premature infant suspected of tracheomalacia. My mentor, Dr. Jean-François Dumon, had sent me to the neonatal intensive care unit even though I had never performed such a procedure. He told me, ‘It’s just like in adults, but smaller!’ Indeed, the procedure went well with a pediatric rigid bronchoscope, and I even found the intubation easier since the glottis is more exposed in children.
I would like to emphasize that, for me, pediatric endoscopy is a limited field and generally only applies to older children. I have noticed much less involvement from my pediatric colleagues regarding the indications for therapeutic bronchoscopy or the placement of stents for central airway pathologies. However, when these cases do arise, I am particularly motivated to help these young patients live as long as possible under the best possible conditions.
Biography
Professor Guy Dutau was born on January 19, 1941, and has dedicated his life to advancing the frontiers of pediatrics. His early work as a pediatric endocrinologist laid the groundwork for a milestone in French healthcare: he pioneering the national screening method for neonatal hypothyroidism. Over time, Prof. Dutau’s passion for children’s respiratory health led him to devote himself fully to pediatric pulmonology and allergology. Around 1980, he joined forces with other French pediatric pulmonologists—most notably Professor Pierre Scheinmann—to create the Inter-University Diploma of Allergology, a two-year program that expanded specialized training opportunities for French-speaking medical professionals worldwide.
At Purpan-Toulouse University Hospital (CHU), he led the Pediatric Department, guiding the planning and launch of a new children’s hospital in 1998. His leadership extended even further when he became Head of the Medical Department from 1998 until his retirement in July 2001, guiding teams toward innovative treatments and collaborative research.
Prof. Dutau’s influence extends beyond France, thanks to his active role in organizing international pediatric pulmonology conferences, including the CIPP (Congrès International de Pneumologie Pédiatique. i.e. World Congress of Pediatric Pulmonology, until 2023, date of the passing of Dr. Annie Bidart, Nice), and JMAP (French Mediterranean Days of Pediatric Allergology, organization; A. Bidart, A; Grimfeld, G. Dutau, A, Labbé). Through these global collaborations and lifelong dedication, he has left a lasting legacy—one that continues to inspire medical professionals committed to transforming the landscape of pediatric health.
Professor Hervé Dutau is a leading figure in the field of interventional pulmonology and currently heads the Interventional Pulmonology Unit and Thoracic Endoscopy Unit in Marseille, France—an institution originally founded by Jean-François Dumon, widely considered the father of this specialty. Prof. Dutau’s clinical expertise includes therapeutic bronchoscopy, airway stenting, central airway disease management, bronchoscopic lung volume reduction, and endobronchial laser procedures.
Beyond his clinical work, he is deeply committed to advancing the discipline through research, publications, and the organization of high-profile educational events. Among his notable achievements are chairing the 1st European Congress of Bronchology and Interventional Pulmonology in 2011 and the World Congress of the WABIP in 2022, both held in Marseille. In recognition of his significant contributions, Prof. Dutau was honored with the WABIP-Dumon Award in 2020—a testament to his enduring dedication to improving patient outcomes and shaping the future of interventional pulmonology.