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New endoscopic procedure helps lung patients breathe easier

Published on Sunday, November 1, 2020

By: Ruth Cummins, ricummins@umc.edu

A new lung procedure performed by University of Mississippi Medical Center specialists is giving relief to patients who cope with breathing challenges wrought by emphysema and chronic obstructive pulmonary disease.

Various treatments for emphysema and COPD now include a minimally invasive procedure called an endoscopic lung volume reduction. It places one or more one-way valves in the diseased portion of the lungs, closing them off and directing breathing activity to the healthy lung area. Patients typically have a three-day hospitalization stay.

Portrait of Michal Senitko
Senitko

The procedure restores quality of life and allows patients to resume many activities that shortness of breath prevents them from enjoying, said Dr. Michal Senitko, UMMC assistant professor of medicine and surgery and section chief of interventional pulmonology. He and his medical team are the first in the state to perform that particular procedure, which received FDA approval in 2018.

Pulmonologist Dr. Yanglin Guo, right, and respiratory therapist Clint Slade, left, prepare equipment for use in the lung volume reduction procedure.
Pulmonologist Dr. Yanglin Guo, right, and respiratory therapist Clint Slade, left, prepare equipment for use in the lung volume reduction procedure.

Patients who are candidates for the procedure cope with obstruction of the air traveling down the windpipe and into the lungs through two large tubes, or bronchi, located inside the lungs. The lungs rely on the natural elasticity of the bronchial tubes and air sacs to thrust air out of the lungs, but their disease robs them of the elasticity and the air becomes trapped. That makes the lungs hyper-inflated, producing shortness of breath, wheezing and coughing.

The surgery is performed under general anesthesia. Using a bronchoscope with a camera attached to the end, Senitko inserts the bronchoscope into the airway and deploys tiny one-way valves into the disease lobes. The valves block the damaged areas of the lungs, preventing air from traveling there. It causes the diseased portion to collapse, giving more space for the healthy portions of the lobe to expand.

In evaluating patients, Senitko said he and his team look carefully at how much their lungs are hyper-inflating.

Dr. Michal Senitko, right, goes over video of a lung volume reduction with resident Dr. Clifford Coile.
Dr. Michal Senitko, right, goes over video of a lung volume reduction with resident Dr. Clifford Coile.

“They have a constant feeling that they can’t take a deep breath, because their lungs are full of air,” he said.

Tina Price of Crystal Springs said she felt an immediate difference in her ability to breathe after waking up from the procedure performed in September. Ever since a 2014 hospitalization for double pneumonia that required her to be placed on a ventilator, she has coped with emphysema and struggled to breathe. Price eventually went on oxygen at her home, and doctors floated the possibility of a lung transplant.

“I told them that would not be happening,” said Price, 55. “It takes too long, it takes too much out of your life, and I have children and grandchildren.”

Her UMMC pulmonologist, Dr. Trey Abraham, associate professor of medicine, proposed lung volume reduction. Thanks to the procedure, Price said, “I don’t have to gasp for air anymore. If I overexert, I feel it, but it’s a lot better than it was. A lot better.” 

Lung volume reduction is one of a growing number of novel procedures performed by Senitko and his team to help Mississippians whose lungs, for a variety of reasons, aren’t functioning well enough for them to comfortably breathe.

“It’s important to build an advanced program, also for benign diseases, with a variety of new and novel treatments for COPD, emphysema, bronchitis and asthma,” he said. “This is becoming the standard of care in the nation and world.”


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