A bullectomy surgery is helpful for patients having chronic obstructive pulmonary disease (COPD). This surgery is for patients who have suffered a certain type of lung damage caused by emphysema. The surgery is performed to remove areas of damaged air sacs in the lungs. Bullectomy is usually performed on large areas of damaged tissue. These damaged air sacs in the lungs tend to combine and then form larger spaces within the pleural cavity, the cavity that contains your lungs. Emphysema can be of many different types, and there is one particular type that commonly affects the upper part of your lungs. This kind of emphysema, as it progresses, destroys the walls of the tiny air sacs that are present in the lungs. Known as alveoli, when the walls of these millions of tiny air sacs get destroyed, it causes these tiny sacs to combine together to form larger air sacs known as bullae. Let us see how this affects our health and what a bullectomy surgery entails.
What is a Bullectomy Surgery?
A bullectomy is a surgical procedure performed in order to remove damaged air sacs in the lungs. These tiny air sacs get together forming a space within the lungs called the pleural cavity. This type of surgery is used to help patients suffering from chronic obstructive pulmonary disease (COPD). COPD is a lung disease caused by smoking or exposure to gas fumes for a sustained period of time.
Bullectomy is helpful for patients who have suffered lung damage caused by emphysema. There are many different types of emphysema and there is one particular type that affects the alveoli of the lungs. This sort of emphysema destroys the walls of millions of tiny air sacs that line our lungs, known as alveoli. When the walls of these alveoli get destroyed, it causes these sacs to combine to form larger air sacs known as bullae. Bullae do not have any role to play in the functioning of the lungs and instead, just take up space in the lungs, pressing down on the healthier sections of the lungs that surround it. This pressing down prevents blood from flowing to the healthier parts of the lungs and can also stop those sections from functioning as well as they should absorb oxygen. This phenomenon often causes a worsening of COPD symptoms.
When is a Bullectomy Surgery Done?
If the bullae that form in the lungs are bigger than 1 centimeter, then a bullectomy surgery is used to remove it. As bullae start putting pressure on the healthy sections of the lungs, it makes it difficult to breathe and also worsens the symptoms of COPD, causing the following.
- Tightness in the chest.
- Feeling tired or fatigued frequently.
- Swelling of feet, legs, and ankles.
- Frequent coughing up of mucus, particularly in the early mornings.
After the bullae are removed through a bullectomy, you will be able to breathe easily and some of these symptoms of COPD will also reduce in severity. Bullectomy is also required because complications may also arise with the bullae. If bullae start to release air, then it can cause your lungs to collapse. If this complication happens more than once, then your doctor will recommend that you undergo a bullectomy. A bullectomy is also necessary if the bullae start to take up more than 30 percent of space in your lungs.
What Are The Different Medical Conditions In Which Bullectomy Is Performed?
A bullectomy is also useful in the following conditions.
- Marfan Syndrome. This is a condition that weakens the connecting tissues in bones, eyes, blood vessels, and the heart.
- HIV-Associated Emphysema. Being HIV-positive increases the risk of developing emphysema and bullectomy surgery helps alleviate it.
- Sarcoidosis. This is a condition in which sections of inflammation, called granulomas, begin to grow in your lungs, eyes, and skin.
- Ehlers-Danlos Syndrome. This is also similar to Marfan syndrome, and it also causes weakening of the connective tissues in your joints, blood vessels, and skin.
Preparing for a Bullectomy Surgery
To begin with, your doctor will first conduct a full physical examination to make sure that you are healthy to undergo the bullectomy surgery. Your doctor will also run the following imaging tests of your chest.
- CT scan. This imaging test uses X-rays and computers to take photos of your lungs. CT scans are used as they provide more detailed pictures when compared to x-rays.
- X-ray. This test makes use of minute amounts of radiation to take pictures of the inside of your body.
- Angiography. This imaging test makes use of a contrast dye to allow your doctors to view your blood vessels and measure how well they are working with your lungs. Once these imaging tests are completed, your doctor will schedule some preoperative visits with you to discuss the details of the bullectomy surgery. An important point is that you will need to quit smoking before you can undergo a bullectomy. Also, allow yourself the proper amount of recovery time so that you can heal properly. It is also advisable that someone accompanies you on the day of the procedure, as you will not be able to drive yourself immediately after the bullectomy surgery procedure. Also, you are not supposed to eat or drink anything at least 12 hours prior to the bullectomy surgery.
How is the Bullectomy Surgery Performed?
General anesthesia is administered to make you fall asleep and not feel any pain during the bullectomy surgery procedure. Then the following steps are taken by your surgeon.
- A small cut is made near your armpit to open your chest. This is called a thoracotomy. If needed, your surgeon can also make several small cuts on your chest for performing a video-assisted thoracoscopy (VATS).
- A thoracoscope and surgical tools are inserted to explore the inside of your lungs on a video screen. If your surgeon is performing VATS, then this procedure might involve a console from where your surgeon will perform the surgery using robotic arms.
- The bullae are removed, along with any other damaged parts of your lung.
- The cuts are closed with sutures.
What Does Bullectomy Recovery Look Like?
After waking up from your bullectomy surgery, you will notice that you have a breathing tube in your chest along with an intravenous tube. This will cause some discomfort but with administration of pain medication most of the pain can be managed post bullectomy surgery. A bullectomy procedure is not an outpatient procedure and you will require an inpatient stay for at least a week. However, a complete recovery from bullectomy takes a few more weeks after the completion of the procedure. Keep the following in mind during your recovery period.
- Don’t miss any follow-up appointments scheduled with your doctor.
- Complete any cardiac therapy if your doctor recommends.
- You have to avoid smoking as smoking increases the risk of bullae forming again.
- A high-fiber diet is recommended after the surgery to prevent constipation from any medications.
- Do not apply any lotions or creams on the incision site till all of them have healed properly.
- Pat your incision site dry after taking a shower. Water in that area increases the risk of infection.
- Do not return to work or start driving until the time your doctor gives you a go-ahead.
- Don’t lift anything heavy for the next three to four weeks.
- Avoid air travel for a few months after the bullectomy surgery.
You will notice that you will be able to resume your normal day-to-day activities within a few weeks after your bullectomy surgery. Proper rest is required so that your body has the time to heal properly post bullectomy surgery.
Complications of a Bullectomy
A bullectomy is generally a safe surgery, having few complications in most cases. However, in about 1 to 10 % of people, a bullectomy can cause complications. Your risk of complications also increases if you have late-stage COPD or if you smoke. Some of the complications that may arise from a bullectomy include.
- Weight loss.
- Fever over 101oF (38oC).
- Infections at the surgical site.
- Heart disease.
- Heart failure.
- Air escaping from the chest tube.
- The levels of carbon dioxide present in the blood become abnormal.
- Pulmonary hypertension.
If you notice any of these complications, you should inform your doctor and seek medical help immediately.
Your doctor may recommend a bullectomy if you are suffering from COPD or any other respiratory condition. While there are some risks associated with a bullectomy, it does have many benefits as well, the primary benefit being that bullectomy can help you breathe better after the surgery. Bullectomy will also give you a better quality of life and may also help some individuals regain lung capacity.