Lung Volume Reduction Surgery
Last Updated 11/02/2020
Authors:Angel Coz-Yataco, MD, FCCP; Margaret Disselkamp, MD; Melissa Lesko, DO, BA; Cybelle Pfeifer, MD
About Lung Volume Reduction Surgery
Lung volume reduction surgery (LVRS) is a procedure to help you breathe easier when your lungs have been damaged by severe chronic obstructive pulmonary disease (COPD). The goal of the surgery is to remove the areas of the lung that are affected by disease. In this way, the remaining lung can work more efficiently. LVRS can help improve your breathing ability and quality of life.
LVRS is not for every patient who has COPD. The patients most likely to benefit from LVRS are those who:
- Have severe lung damage, especially in the upper part of the lung;
- Are younger than 75 to 80 years of age;
- Have not smoked for at least 6 months; and
- Aren’t able to exercise after completing lung rehabilitation.
Before having LVRS, you must be evaluated by a lung specialist (called a pulmonologist) and a doctor who specializes in chest surgery (called a thoracic surgeon). You will have tests, including:
- Lung function tests;
- 6-minute walk test;
- Arterial blood gas;
- Computed tomography (CT) scans of the lungs;
- Electrocardiography (ECG);
- Echocardiogram; and
- A cardiopulmonary exercise test.
What to expect
How LVRS is done
The surgery is performed under general anesthesia. This means that you’re completely asleep and placed on a breathing machine.
Thoracic surgeons can use different techniques for this surgery:
- Median sternotomy. The surgeon makes an incision through skin and bone in the middle of the chest to get to the lung.
- Video-assisted thoracoscopy. The surgeon makes multiple, small incisions on both sides of the chest. He or she uses video and surgical instruments to perform the surgery.
- Thoracotomy. The surgeon makes an incision between the ribs on the side of the chest and separates the ribs to access the lung.
After surgery, how long you spend in the hospital depends on your overall health and whether you have complications from the surgery.
What are the risks?
In every procedure there’s a risk of complications. The most common complications are air leaks—that is, when air escapes from the lung into the chest cavity. A chest tube will drain escaping air from your body. Most air leaks heal in about 7 days. However, some patients have longer periods of air leak and may need a second surgery to fix it.
Other complications include:
- The need for a breathing machine, or ventilator;
- Pneumonia; and
- Blood clots.
Less common complications include infection, heart attack, irregular heart rhythm, and death.