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Surgery may be used to treat a small number of people with COPD. It can improve symptoms, make breathing easier, and sometimes prolong life. However, it cannot cure the disease. Surgical procedures include:

Bullectomy

Bullectomy improves breathing for a small number of people with COPD. This is a rarely done elective procedure. It involves the surgical removal of a large air space, called a bulla, which is filled with oxygen-depleted air. When the bulla is removed, healthy functioning air sacs around it have room to expand. This makes muscles used for breathing work better. Usually only one large bulla is removed.

Surgeons do bullectomy in two different ways. An incision is made in the side of the chest wall between the ribs. This is called a thoracotomy. Then, a tube mounted with a small video camera, called a video thoracoscope, is inserted. Surgical instruments are also attached to the thoracoscope. The surgeon is able to view the lung on a video screen while removing the bulla. The bulla can also be removed through this incision.

Lung Volume Reduction Surgery (LVRS)

This procedure is done to relieve symptoms in people with advanced COPD. Surgeons remove a portion of the most diseased lung tissue. This allows the diaphragm to return to a more normal position. That allows it to work more effectively. This may improve lung elasticity. In some people, surgery can improve symptoms.

Surgeons do LVRS with a thoracotomy. The surgeon removes the diseased lung tissue through a large incision. In another method, surgeons insert a video thoracoscope through a small incision. They remove diseased tissue while viewing the lungs on a video screen (VATS). In both procedures, surgeons remove about 20%-30% of the most damaged lung tissue.

Lung Transplant

A lung transplant is a surgical procedure to remove severely diseased lungs and replace them with healthy lungs from a human donor. One or both lungs may be transplanted. The procedure may be done in people with end-stage COPD.

In a single lung transplant, the surgeon makes an incision on your side, about six inches below your underarm. A horizontal incision across the lower chest is made for a double lung transplant. You will be put on a ventilator and a heart-lung machine. The heart-lung machine takes over the functions of the heart and lungs during the operation. A small section of rib is permanently removed to allow access to your lung. The old lung is cut away from the main blood vessel and bronchus. The new lung is then inserted. The blood vessels and bronchus are attached to the new lung. You will probably remain on medications indefinitely to prevent rejection of your transplanted organs.

References:

COPD. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 20, 2014. Accessed February 24, 2014.

Ernst A, Anantham D. Bronchoscopic lung volume reduction. Pulm Med. 2011:1-6.

How is COPD treated? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/copd/treatment.html. Updated July 31, 2013. Accessed February 24, 2014.

Surgery. American Lung Association website. Available at: http://www.lung.org/lung-disease/copd/living-with-copd/surgery.html. Accessed February 24, 2014.

What you can do about a lung disease called COPD. Global Initiative for Chronic Obstructive Lung Disease website. Available at: http://www.goldcopd.org/uploads/users/files/GOLD_Patient_RevJan10.pdf. Accessed February 24, 2014.



Last reviewed February 2014 by Peter J. Lucas, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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