COPD · TREATMENT OPTIONS
Surgery and Bronchoscopic Treatment Options for COPD: Which Is Suitable for Whom?
Prof. Dr. Yalçın Karakoca · Last updated: 25 September 2026
SHORT ANSWER
When people talk about “surgery” for COPD, two groups of options come to mind. The first group is bronchoscopic treatments, which do not require an incision. These treatments are carried out with a thin tube with a camera at its tip (bronchoscope). The second group is surgery. Among the bronchoscopic treatments, the balloon is used in COPD in which cough and phlegm predominate. In emphysema, lung valves, coils (endobronchial coils) and vapour treatment are used. The surgical options are lung volume reduction surgery and, in highly selected patients, lung transplant. The type of COPD determines which method is considered. None of them replaces medication.
First, the type of disease: chronic bronchitis or emphysema?
COPD is not a single, uniform disease. In some people, the inner lining of the airways thickens and a lot of phlegm is produced (chronic bronchitis). In others, the air sacs are damaged and air builds up in the lungs (emphysema). In most patients, both are present in different proportions. Tests show which one predominates. These are a chest CT scan, a breathing test and lung volume measurements. The choice of treatment is made on this basis. Details: Difference between chronic bronchitis and emphysema.
Comparison table
| Method | Which problem does it target? | How is it done? | Is a device left in the body? | Anaesthesia and hospital stay | Main risks |
|---|---|---|---|---|---|
| Balloon treatment (Karakoca Resector Balloon) | COPD in which cough and phlegm predominate: thickened airway tissue and mucus | A mesh-covered balloon is inflated and deflated several times in the narrowed airways | No | General anaesthesia; usually 1–2 days | Bleeding, temporary drop in oxygen level, flare-up |
| Lung valve (Karakoca Valve and others) | Emphysema: air building up in one lobe of the lung | One-way valve(s) are placed in the airway leading to that lobe; the lobe deflates | Yes (removable) | General anaesthesia or medicines that make you sleepy (deep sedation); 3–5 days of monitoring | Pneumothorax (air leaking between the membranes around the lung), flare-up, the valve moving out of place |
| Coil (endobronchial coil) | Emphysema | Thin metal coils are placed in a part of the lung | Yes (permanent) | General anaesthesia; 1–2 sessions | Pneumothorax, pneumonia, bleeding; the benefit may be limited |
| Vapour treatment | Emphysema: a specific part of the lung | That part is shrunk with heated water vapour | No | General anaesthesia | Flare-up, pneumonia, bleeding |
| Lung volume reduction surgery | Severe emphysema concentrated in the upper parts of the lungs | Surgical removal of the most damaged lung tissue | — | Open or keyhole surgery; 1–2 weeks | Surgical risks, including risk to life; prolonged air leak |
| Lung transplant | End-stage COPD, highly selected patients | Single or double lung transplant | — | Major surgery | Organ rejection, infection, lifelong immunosuppressive medication |
| New methods (freezing spray, rheoplasty, nerve ablation) | COPD in which cough and phlegm predominate (at the research stage) | Freezing spray, short electrical pulses or disabling the airway nerves | No | General anaesthesia | Flare-up, temporary cough |
Which method is considered for which patient?
| Patient’s situation | Considered first |
|---|---|
| Long-lasting cough, a lot of phlegm, airway narrowing; little emphysema on the CT scan; medicines are not enough | Balloon treatment |
| Severe emphysema, air building up in the lungs, a clearly defined lobe to be treated and no air flow between the lobes | Lung valve |
| Severe emphysema, but with air flow between the lobes (a valve is not suitable) | Coil or vapour treatment (methods investigated in research studies) |
| Emphysema concentrated in the upper parts of the lungs, low exercise capacity, suitable for surgery | Lung volume reduction surgery (together with thoracic surgeons) |
| End-stage disease; young, with no other illnesses | Referral to a transplant centre |
| Both types present together | A step-by-step, planned approach based on whichever type predominates |
“Is there surgery for COPD?”
There is no operation that eliminates COPD. Surgery and bronchoscopic methods aim to reduce shortness of breath in selected patients. They also aim to increase exercise capacity and quality of life. The benefits and risks of each method are specific to each person. Whichever method is chosen, medication, the breathing exercise programme and vaccines continue. If you smoke, you need to stop.
PRELIMINARY ASSESSMENT
Is it suitable for you?
Book an appointment and bring your breathing test and chest CT scan reports. We decide together at the consultation. If you are coming from outside Istanbul, an online preliminary consultation can be held first.
Please bring: your breathing test, your chest CT scan report and images (CD/USB), your list of medicines and, if you have one, your blood gas test result.
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SCIENTIFIC STUDIES
HAVE A QUESTION?
Frequently asked questions
The questions our patients and their relatives ask most often, with answers. We discuss questions about your own situation together at the consultation.
APPOINTMENT
Book an appointment for a preliminary assessment
Let’s talk together about which option is right for you. Book an appointment and bring your chest CT scan and breathing test results: +90 212 916 38 23.
info@yalcinkarakoca.com · Rüzgarlıbahçe Mah. Cumhuriyet Cad. Hasoğlu Plaza Kat:3, Kavacık / Beykoz, İstanbul
This page is for general information purposes. It does not replace a medical examination or diagnosis. Treatment decisions are made during an examination, on an individual basis. In an emergency, call 112.
Medical content review: Prof. Dr. Yalçın Karakoca, Pulmonologist · Last updated: 25 September 2026
References
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