Bullous Emphysema and Surgical Treatment: Rediscovering Breathing

What is Bullous Emphysema?
Bullous emphysema is characterized by abnormal expansion of the air sacs (alveoli) in the lung tissue and thinning of their walls. This leads to the formation of 'bullae', which are large air sacs. Bullous emphysema can cause shortness of breath, chest pain, and other breathing problems.

Diagnostic Process
In this section, let's talk about the methods used to diagnose bullous emphysema. These include a chest X-ray, computed tomography (CT) scan, and pulmonary function tests.

When is Surgical Intervention Required?
Let's talk about the situations of bullous emphysema that require surgical intervention. Usually, surgical treatment is recommended when bullae are large in size or symptoms such as shortness of breath worsen. It is important to surgically remove the bullous areas because the bullae, which do not have the function of breathing in and out, take up space in the chest and suppress the normal lung function, hindering its function.

Surgical Treatment Options for Bullous Emphysema

1. Bullectomy

Bullectomy involves the surgical removal of large and symptomatic bullae. This procedure generally follows the following steps:
Patient Preparation and Anesthesia: Patients are processed under general anesthesia.
Closed Surgical Access: One or more small incisions are made in the chest wall. 
Removal of Bullae: Bullae are carefully removed without damaging the surrounding tissue.
Closure and Healing: The incisions are closed and the patient is monitored for postoperative care.
This procedure can help relieve symptoms such as shortness of breath and improve lung function.

2. Lobectomy- Pneumonectomy

It is applied in three different ways;

A- Video Assisted Thoracoscopic Surgery (VATS)

VATS is a minimally invasive technique and has the following features:
Minimally Invasive Approach: Very small incisions are made in the chest wall.
Video Assistance: The surgeon uses a camera to get a better view of the internal organs.
Less Pain and Fast Recovery: VATS is less painful and recovery time is shorter than traditional open surgery.
This method is especially preferred depending on the location and size of the bullae.
B. Robotic Surgery

It is the most current surgical method. Like VATS, it is a closed (minimally invasive) surgery performed by placing the arms of the robot into the chest through multiple 1cm holes. A camera and 2 arms are placed inside the chest, allowing a more meticulous surgery to be performed with a 3D image and sensitive surgical instruments. 
Advantages;

It provides less pain,
fewer complications,
earlier recovery, discharge and return to work and social life.

    C. Torokotomi 

It is the classical open surgical method.

Risks and Benefits of Surgery

As with any surgical procedure, bullectomy and other procedures have risks. These may include bleeding, infection, and anesthesia-related complications, but they are extremely rare. However, a successful operation can significantly improve respiratory function and improve quality of life.

Lifestyle Changes and Supportive Treatments

Let us emphasize that, in addition to surgical treatment, lifestyle changes such as smoking cessation, regular exercise and breathing exercises are important in the management of bullous emphysema. Additionally, oxygen therapy and drug treatments are among the supportive treatment options.
Bullous emphysema can be a difficult condition to manage, but with robotic surgical treatment and lifestyle changes, symptoms can be controlled and quality of life improved.