People who suffer from emphysema have a chronic condition in which the air sacs in the lungs become enlarged, making breathing more difficult. The disease can cause obstruction of the airways -- trapping the air and making it difficult to exchange oxygen because the lungs become less elastic, like a used rubber band. Smoking is the primary risk factor for this condition.

While there is currently no cure for emphysema, which gradually worsens over time, there are treatments to help people manage the disease. If you have emphysema and also smoke, you should stop smoking immediately. Smoking, in most cases, is the cause of this disease.

Medications, inhalers and supplemental oxygen are generally used to control emphysema. For advanced stages, lung transplant may be recommended. The majority of patients awaiting lung transplant suffer from emphysema and may be candidates for a newly refined procedure called Lung Volume Reduction Surgery.

Lung Volume Reduction Surgery

Lung Volume Reduction Surgery (LVRS) is an innovative surgical procedure by which surgeons remove 20 to 30 percent of the lung tissue most damaged by emphysema. The surgery allows the remaining portion of the lungs to function more efficiently and the patient to breathe more easily. View an Ask an Expert video to learn more about this procedure.

Clarian is the only hospital in Indiana to qualify under the Centers for Medicare & Medicaid Services to perform LVRS. To be qualified, Medicare requires hospitals to have an active lung transplant program. Our lung transplant program is among the largest by volume in the country. With the help of our extensive pulmonary and transplant experience, we have developed the region's premier LVRS program.

To find out if you qualify for LVRS, talk to your doctor or see your pulmonologist. If you aren't currently seeing a specialist for this condition, locate one near you. Patients must have severe emphysema and meet specific medical requirements to be considered for this surgery.

LVRS is a high-risk surgical procedure due to candidates' poor lung function and older age, but it's an effective alternative to -- or first step toward -- transplant. However, research conducted by the National Emphysema Treatment Trial helped to identify the best surgical solution. Clarian physicians take great care when evaluating whether those who suffer from emphysema qualify for this procedure.

Patients considering this operation should be aware of the following potential complications:

• Air can leak from the suture line in the lung tissue into the chest cavity. Surgeons use chest tubes to monitor and prevent air leakage.
• Lung infections and pneumonia are possible, especially if patients have previously experienced these illnesses.
• Stroke (less than 1 percent chance).
• Bleeding (less than 5 percent chance).
• Heart attack (less than 1 percent chance).
• Worsening of the above complications might cause a combination of problems that could lead to death (6-10 percent chance).

Surgical Techniques:

Thoracoscopy -- This is a minimally-invasive technique that involves three small incisions that are made in each side between the ribs. A video-scope is used by the surgeon to view the lungs. The surgeon uses a device to cut away part of the damaged lungs and uses a stapler to reseal the lung. Sutures will eventually dissolve. Because the procedure is minimally invasive, patients generally recover quicker than those who undergo other surgical methods.

Sternotomy -- An incision is made between the breastbone to expose both lungs. The surgeon can reduce damaged tissue of both lungs using this procedure. This technique is generally used when damage is in the upper lobe area. This surgery is the most invasive.

Thoracotomy -- A 5- to 12-inch incision is made between the ribs, enabling them to be separated but not broken so the surgeon can view the lungs. Only one lung is reduced with this procedure, which is generally used when the surgeon can't see the lung clearly through the thoracoscope and when scar tissue is present.

During pre- and post-operative phases, patients will be given various breathing exercises to condition their lungs before surgery and to expand and condition lungs afterward. Post-operative rehabilitation will also include exercises for overall conditioning. Exercise programs may consist of walking, treadmill or bicycling. Pre- and post-op rehabilitation can make a huge difference in how quickly patients recover and the long-term success of the procedure.