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:
