COPD Surgery & Minimally Invasive Proceduress

Emphysema damages the air sacs of the lung. This causes them to over-inflate and enlarge. Very large air sacs are called bullae. If these large sacs are close together (not spread throughout the lung), then your surgeon can perform a bullectomy to remove them.

After removing them, the large sacs are no longer pressing on the healthy lung. Therefore, the remaining healthy tissue functions better for easier breathing.

Endobronchial valves are a minimally invasive treatment option for people with severe COPD or emphysema. The valves are implants that fit in the airways of your lungs. The surgeon places the valves in selected airways during a bronchoscopy procedure. This procedure requires no incisions (cuts). It is an alternative to the more invasive traditional lung volume reduction surgery.  

How Endobronchial Valves Work 

If you have severe COPD or emphysema, you may struggle to catch your breath while doing everyday tasks. This is because the damaged parts of your lungs have lost their ability to release trapped air and have become overinflated. Endobronchial valves are tiny, one-way valves that allow you to exhale the trapped air from your lungs. The valves also prevent more air from becoming trapped in those damaged areas of lung.

By deflating the overblown portion of the lung, the valve helps reduce the volume (size) of the diseased and over-inflated lung. Healthier lung tissue can expand and function more normally.

Candidates for Endobronchial Valves

Lung volume reduction using endobronchial valves may be an option if you have COPD or emphysema and:  

• Are not responding to medicine. 
• Are too sick to undergo surgery. 
• Have reduced lung function. 

Prefer not to undergo surgery.   

Studies have found that the devices can make it easier for you to breathe, exercise and enjoy everyday life. Doctors in the COPD Clinic can determine if you are a candidate for this approach.  

What to Expect

Under anesthesia, the doctor will insert a small tube with a camera (bronchoscope) through your mouth. The doctor will place small, umbrella-shaped, one-way valves inside your airways that lead to the most diseased part of your lung.  

During the procedure, your doctor will place about four valves in your airways. The number of valves the doctor places depends on the anatomy of your airways and other factors.  

The valve stops inflow and allows the trapped air in the diseased tissue to escape. This allows the healthier areas of the lung to breathe easier. 

After the Procedure

You’ll spend at least three nights in the hospital. If you experience complications, you may need to stay longer.  After the procedure, you will continue to use the medicines that your doctor has prescribed for your condition. 

Emphysema destroys lung tissue. The hyperinflated (enlarged) portion of the lung compresses the relatively normal parts of the organ and limits its function. Lung volume reduction surgery (LVRS) removes the hyperinflated portion of one or both lungs, most of which is non-working tissue.

This gives the remaining healthier lung(s) and breathing muscles (diaphragm and muscles in between the ribs) more room to expand in the chest cavity for easier breathing.

A small percentage of those with COPD may be candidates for organ transplantation to replace one or both lungs. Although COPD affects approximately 30 million Americans, only a few hundred will undergo lung transplantation.  

Our multidisciplinary team can determine whether you might be eligible to undergo lung transplantation. If so, we can assist in referring you to our partner lung transplantation centers in Boston. We can also provide follow-up care once you have had a lung transplant.   

Candidates for Lung Transplant

You are most likely to benefit from lung transplant if you have: 

• Cystic fibrosis (CF): an inherited disease that causes a build-up of mucus (and bacteria) in the lungs and other organs. 
• Emphysema: caused by alpha-1 antitrypsin deficiency. 
• Idiopathic (unknown cause) pulmonary arterial hypertension (IPAH): increased pressure in the pulmonary arteries that causes shortness of breath, chest pain and other symptoms that may eventually limit all physical activity. 
• Idiopathic (unknown cause) pulmonary fibrosis (IPF): when tissue deep in the lungs becomes scarred over time (fibrosis) and cannot exchange oxygen. 
• Severe COPD.