Me and my operation: The tiny bell that breathes life back into your lungs
22:20 GMT, 7 May 2012
Every year 900,000 Britons are diagnosed with lung conditions such as emphysema and chronic bronchitis which leave them breathless. Susan Matthews, 62, a retired administrator from Wiltshire, underwent a new, non-invasive treatment.
And breathe: A bell-shaped valve has transformed the life of one emphysema sufferer
Twelve years ago, I started feeling breathless when I was walking uphill or for long distances.
At the time I assumed I was just out of shape: as an administrator my day was fairly sedentary. I’d also, ashamed as I am to admit it, smoked on and off for the previous 20 years — up to 20 cigarettes a day.
The breathlessness got worse, and five years after the symptoms started I went to see my GP. /05/07/article-2140999-0C9EB1A2000005DC-711_468x351.jpg” width=”468″ height=”351″ alt=”It takes your breath away: Emphysema is strongly linked to smoking (file picture)” class=”blkBorder” />
It takes your breath away: Emphysema is strongly linked to smoking (file picture)
Normally, when we breathe in, air travels down the main airway, the trachea, into microscopic air sacs in the lungs called alveoli. Here, oxygen is absorbed into the blood before the air is breathed out.
When someone develops emphysema or chronic bronchitis, some of these microscopic air sacs become damaged. This means that not all the air that should be expelled is actually breathed out and about 10 per cent of it remains trapped in the lungs.
As a result the lungs become overinflated over time and there is less space for taking air in. The body compensates by taking shorter breaths, leading to breathlessness. The lung tissue can become so damaged that the condition can be fatal.
Operating to reduce this over-inflated area of the lung is thought to be the best way to resolve the problem.
However, this is quite risky since emphysema patients are already unwell. It also means a long hospital stay and, as with all operations, carries the risk of infection.
Endobronchial lung volume reduction can achieve the same results, but with a minimal risk of complications as there’s no open surgery involved.
It involves placing a one-way, bell-shaped valve (about 10mm long and 5mm wide) in the bronchi, the tubes that run into the alveoli, in the most over-inflated part of the lungs.
When the patient breathes in, the valve closes and prevents air being directed to the damaged part of the lung, so preventing further inflation.
However, when the patient breathes out, trapped air is able to flow through the valve and out of the lung. This improves the patient’s ability to breathe, and of course it allows them to be more active, which improves their overall wellbeing.
Depending on a patient’s condition, the number of valves used can vary from one to 15.
The procedure was trialled at the Royal Brompton Hospital, West London, around two years ago, and is available in a limited number of NHS hospitals, but there are plans to make it more widely available.
With the patient under sedation, I place a special camera on a tube (a video bronchoscope) down the mouth and directly into the damaged area. This transmits images of the lung onto a computer screen so that I can see exactly where to place the valve.
The valve, which is made of mesh, is then compressed into a catheter (a thin tube) and put down the throat.
Once guided to its exact location, the valve is pushed out of the catheter where it expands to its full width. The valve creates an airtight seal against the wall of the bronchi to prevent air from leaking around the device.
The valve stays in place because of internal pressure in the body, so then we simply withdraw the catheter and camera back through the mouth.
As there’s no invasive surgery there is no risk of infection, no need for painkillers and the effects are almost immediate.
The procedure costs 10,000 to 15,000 privately, depending on the number of valves used, with a similar cost to the NHS.