Sebastian Fernandez-Bussy, M.D.: So patients who have COPD, they could have emphysema, which is damage of the lung tissue. And they get like holes in the lungs because of this damage. And they have problems breathing and their quality of life is poor because of this. Now chronic bronchitis patient are also part of the COPD group. That means chronic inflammation of the airways. And also a third group is a combination of emphysema and chronic bronchitis. So those patients with advanced emphysema that have these holes in the lungs, those holes interfere with the oxygen, with the availability of the oxygen to go into the bloodstream and the CO2 to get out of your body.

Fernandez-Bussy: So that's one of the reasons they have difficulty breathing. But the other reason is that the lungs of people with advanced emphysema, because of these holes, are very big. So this increase in size interferes with the patient taking a big breath. Their lungs are already too big in the chest cavity, so they cannot take a deep breath. That's why we need to reduce the volume — so shrink that part of the line that has the most emphysema.

Fernandez-Bussy: So patients who have advanced emphysema can undergo our full medical treatment and still their breathing is not good. We can provide a minimally invasive treatment, which is called endoscopic lung volume reduction. And what we do is place endobronchial valves, bronchoscopically. So this is not a surgery. This is a procedure.

Fernandez-Bussy: So the patient is under anesthesia, and we go down with a small scope through the mouth, into the lungs. And we go to the place that we have already pre-selected that has the most damage. And over there we place very tiny valves that are one-way valves. That means that they do not allow air to go into that part of the lung, but it will allow air to get out of that part of the lung. So with time, the part of the lung that has the most emphysema will get deflated. It will shrink. And that will allow the rest of the lung with less emphysema to have more space to expand and function. And the people will achieve a better breathing and a better quality of life.

Fernandez-Bussy: So the benefit of shrinking the lung for the patient is to improve their breathing. So they will be able to take bigger breaths. And also they will be able to need less oxygen if they are already on oxygen or maybe come off oxygen. This treatment does not cure emphysema. So what it does is improve the quality of life of these patients by improving their breathing. So in the past, surgical lung volume reduction was the only option for this patient to achieve this lung volume reduction. But now, with endoscopic lung volume reduction, we can increase the range of patients that are eligible to this type of procedure and with less morbidity.