Africa’s first endoscopic lung volume reduction surgery

A doctor points to an X-ray showing a pair of lungs. Picture: File

A doctor points to an X-ray showing a pair of lungs. Picture: File

Published Apr 28, 2023

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Pretoria - A team of doctors from the Netcare Kuils River Hospital in Cape Town have not only advanced the state of health care in the country but put Africa on the map with the first endoscopic lung volume reduction surgery.

The procedure, offered by only a few healthcare facilities around the globe, uses endobronchial valves.

It was recently performed at the Cape Town hospital, giving hope of improved quality of life to patients living with chronic obstructive pulmonary disorder (COPD).

The procedures were performed by pulmonologists Professor Coenie Koegelenberg from the Stellenbosch University’s Division of Pulmonology at the Department of Medicine, and Dr Dante Plekker, both of whom practise at the hospital.

“COPD is a chronic lung disease that usually occurs in current or former smokers. Typical symptoms include breathlessness, coughing and wheezing and it’s caused by varying degrees of damage to the small air sacks or alveoli, ultimately resulting in emphysema and chronic inflammation of the airways,” Plekker said.

“This leads to an inability of the lungs to empty completely when exhaling, causing the lungs to become hyperinflated with less space in the chest to breathe with. The condition can cause debilitating breathlessness, even during minimal daily activities such as washing and dressing, resulting in a poor quality of life.”

Plekker said the typical treatment of chronic obstructive pulmonary disorder included smoking cessation, inhaled medications, as well as pulmonary rehabilitation, but despite this many patients continued to suffer from severe symptoms.

The procedure could be considered an additional treatment option for these patients.

Koegelenberg added that multiple high-quality clinical trials had indicated the procedure could improve symptoms as well as lung function, enhancing quality of life in patients with COPD and emphysema who meet the selection criteria to undergo the procedure.

“During this minimally invasive procedure, a flexible fibreoptic camera or bronchoscope is used to insert small one-way valves into the lobe of the lung that is most impacted by the disease.

“This aims to deflate the treated lobe so airflow can be redirected to healthier parts of the lungs.

“The procedure reduces hyperinflation and improves the mechanics of breathing. It however does not cure COPD or emphysema.”

The fortunate patient, 66-year-old Charmaine Henning, first diagnosed with severe COPD in 2019, said she noticed a significant improvement in her breathlessness just a few days after the procedure.

Henning said for years she had been left unable to perform even the most basic activities without pausing to catch her breath.

“I cannot believe it but the very next day, even that very same afternoon after the procedure, I could feel a difference.

“Before my procedure I was terribly tired, I could not walk the few steps from my room to the en suite bathroom without having to sit down.

“Even when speaking to someone, I had to ask them to hold on so I could get my breath back but all that has changed.

“Now every morning when I wake up I think how amazing it is that things changed so quickly for me after the procedure. My family cannot believe that I am not out of breath.

“I’m so proud of the two of doctors and the entire team they did the procedure fantastically and I know it was not easy,” said the mother of two and grandmother of six.

According to a position statement on endoscopic lung volume reduction in South Africa 2022, published on behalf of the Assembly on Interventional Pulmonology of the South African Thoracic Society, COPD remained one of the most common causes of morbidity and mortality, both in South Africa and globally.

Pretoria News