For those that suffer from emphysema, a few therapies and approaches to managing are available. Treatment generally involves education about the disease, medications such as bronchodilators or steroids, breathing treatments, and using oxygen as the disease gets worse.

Lung volume reduction surgery (LVRS) is a therapy that may be appropriate to help you. This type of surgery treats emphysema predominantly in the upper regions of the lungs. It is used strictly for people with emphysema or bullous lung disease.

It is not effective as a treatment for asthma, interstitial lung disease, chronic bronchitis, or bronchiectasis.

This surgery is not done to "cure your lung disease," but to give you an improvement in the quality, and hopefully the duration of, your health and life. A recent large scale clinical trial showed that some patients show significant improvement in their pulmonary function and general feelings of wellness for at least two years after the surgery.

LVRS Details

Everyone who comes to Duke for LVRS evaluation undergoes a series of interviews, tests, and appointments with a pulmonary specialist and/or thoracic surgeon. This process provides as complete a picture as possible to help assess whether this surgery is right for you.

In LVRS, a surgeon removes the portions of the lungs with the worst disease. With the worst part of the over-inflated lungs removed, the remaining lung tissue can expand and contract more effectively during breathing. The smaller lungs also allow the muscles of breathing to function better.

The x-rays and other radiologic studies performed as part of your evaluation show the surgeon where the lung tissue is less effective. Exactly how much of the lungs is removed is determined by the surgeon at the time of surgery.

Surgeons use one of two techniques to do this surgery. In a median sternotomy, the surgeon cuts through the breast bone (sternum) to get to the lungs.

The second method is called video-assisted thoracoscopic surgery (VATS). Two to three small incisions, each about one inch, are made on both sides of the chest. The surgery is performed using specialized instruments and small fiber-optic camera inserted through the incisions between the ribs.

The specific approach used for your surgery will be decided by your surgeon after reviewing all of the appropriate information and during your face-to-face visit.

Physicians

Physicians offering this service include:

• D'Amico, Thomas A.
• Davis, R. Duane
• Harpole, David H. Jr.
• Toloza, Eric M.