Understanding Your Procedure

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Lung Volume Reduction Surgery (LVRS) is a surgical procedure designed to improve breathing in patients with severe emphysema, a type of Chronic Obstructive Pulmonary Disease (COPD). The procedure involves the removal of the most damaged parts of the lungs, allowing the healthier parts to expand and function more effectively. The surgery is performed under general anesthesia. The surgeon makes incisions on either side of the chest to access the lungs and removes up to 30% of the most diseased lung tissue. The remaining lung tissue can then expand more fully, and the diaphragm and other muscles used in breathing return to a more normal position, making breathing easier. LVRS can significantly improve quality of life for patients with severe emphysema. Benefits include improved lung function, reduced breathlessness, increased ability to exercise, and enhanced overall quality of life. Some studies have also shown that LVRS can increase life expectancy for certain groups of patients. However, LVRS is a major operation and, like all surgeries, it has risks, including complications from anaesthesia, infection, and a prolonged recovery period. Therefore, it’s typically reserved for those who have severe symptoms but do not respond to medical therapy. It’s important to note that LVRS is not a cure for emphysema, but it can help manage the symptoms and improve the patient’s quality of life. Patients will still need to use medications and oxygen as prescribed by their doctor, and it’s crucial that they stop smoking before the surgery and do not start again afterwards.

Bronchoscopic Lung Volume Reduction (BLVR) is a minimally invasive procedure developed in the early 2000s as a treatment for severe Chronic Obstructive Pulmonary Disease (COPD), primarily caused by emphysema. BLVR involves the use of endobronchial valves, coils, or thermal vapour ablation. Endobronchial valves are medical devices inserted using a bronchoscope into sections of the lungs damaged by emphysema. These valves allow air to exit these sections but not to re-enter, causing the damaged lung tissue to deflate and reducing the excessive lung volume (hyperinflation) caused by emphysema. Clinical research has found that BLVR confers measurable benefits, including improved lung function, improved exercise tolerance, and a lower risk of injury and infection. However, it also carries risks such as COPD exacerbation, respiratory failure, pneumothorax, and pneumonia.

• Steam Ablation: This technique involves the use of steam to cause scarring and shrinkage in the less functional areas of the lung. A bronchoscope is used to deliver steam to targeted areas of the lung. The heat from the steam causes the affected lung tissue to scar and shrink, reducing the volume of the diseased lung. This allows the healthier parts of the lung to expand and function more effectively. The procedure is minimally invasive and can be performed under local anaesthesia, reducing the risk of complications and recovery time.
• Targeted Lung Denervation (TLD): TLD is a novel approach that involves disrupting the nerve supply to the smooth muscles in the airways. This can help to reduce airway constriction and improve lung function. The procedure is performed using a bronchoscope, which is inserted through the mouth or nose and into the lungs. A special catheter is then used to deliver radiofrequency energy to specific nerves in the lungs, disrupting their function. This can help to relax the airways and improve breathing.
• Lung Volume Reduction Coils (LVRC): LVRC is a minimally invasive procedure that involves the placement of nitinol coils into the airways of the diseased parts of the lung. The coils help to compress the diseased lung tissue and allow the healthier parts of the lung to expand and function more effectively. The procedure can lead to improvements in lung function, exercise capacity, and quality of life, although the results can vary greatly between patients.
• AeriSeal: The AeriSeal System is designed to limit collateral ventilation, which is caused by openings in the lung fissures, or walls between the lung lobes. The system works by occluding these naturally occurring openings in a lobe targeted for bronchoscopic lung volume reduction (BLVR), blocking collateral ventilation. Successful treatment with the AeriSeal System is followed by treatment with commercially available Zephyr Valves.