Support Local Journalism. Join Riverfront Times Press Club.

Removing a Doorstop 

The theory behind Dr. Joel Cooper's lung-volume-reduction technique is as simple as closing a door

The idea behind lung-volume reduction is as simple as the idea of removing a doorstop so you can close a door.

As Dr. Thomas Egan, head of the lung-transplant program at the University of North Carolina, explains, the procedure involves the "taking out of a part of the lung that is doing nothing but occupying space." That lets the patient's diaphragm and chest muscles collapse back toward their normal size, helping the patient regain freedom of movement and improving breathing.

Think of your chest as a balloon pump or bicycle pump. When you expand your diaphragm and chest muscles, they draw air into your lungs, just as a pump draws in air when you pull back the handle. When you contract the muscles of your chest wall and diaphragm, they squeeze air out of your lungs.

Emphysema overstretches your lungs so much that they can't contract. Try as you may, you can't squeeze the air out of them. It is as if someone stuck something under your rib cage and diaphragm to keep them stuck in an expanded position, much like someone putting a stop between a door and jamb so the door won't close. The rib cage and diaphragm can't push out the air in your lungs, and they can't expand much more to draw in new air.

In screening patients for lung-volume reduction, surgeons look for people whose emphysema is unevenly concentrated in small parts of their lungs, which are otherwise composed of relatively healthy tissue. Then they can cut out the useless parts of the lung that are propping open the diaphragm and chest, leaving enough healthier parts that the patient can get enough air to live on.

The operation itself only takes about an hour, and with the technique Dr. Joel Cooper of Barnes-Jewish Hospital uses, most of that time is spent carefully sewing the rib cage and chest muscles back in place to minimize scarring.

Support Local Journalism.
Join the Riverfront Times Press Club

Local journalism is information. Information is power. And we believe everyone deserves access to accurate independent coverage of their community and state. Our readers helped us continue this coverage in 2020, and we are so grateful for the support.

Help us keep this coverage going in 2021. Whether it's a one-time acknowledgement of this article or an ongoing membership pledge, your support goes to local-based reporting from our small but mighty team.

Join the Riverfront Times Club for as little as $5 a month.

More by Peter Downs

Read the Digital Print Issue

November 24, 2021

View more issues


Never miss a beat

Sign Up Now

Subscribe now to get the latest news delivered right to your inbox.

Best Things to Do In St. Louis

© 2021 Riverfront Times

Website powered by Foundation