What is Lung Volume Reduction Surgery (LVRS)?
Lung volume reduction surgery is used to improve breathing in some people with severe emphysema, a type of chronic obstructive pulmonary disease (COPD).
During surgery, small wedges of damaged lung tissue are removed to allow the remaining tissue to function better. After surgery, people often have less shortness of breath, have better quality of life and are better able to exercise.
When is Lung Volume Reduction Surgery (LVRS) needed?
Lung volume reduction surgery is used for some patients with severe emphysema, a common type of chronic obstructive pulmonary disease (COPD), disabling dyspnea (shortness of breath, difficulty breathing), and evidence of severe air trapping (air is “trapped” in the lung and cannot get out because of the emphysema or other lung disease).
What should you know before undergoing Lung Volume Reduction Surgery (LVRS)?
Not everyone can safely undergo this procedure. Although selecting candidates for LVRS is subjective, criteria identifying good candidates for LVRS include people:
- Who have severe emphysema that does not respond to medical therapy.
- Who are younger than 75 to 80 years old.
- Who have not smoked for at least 4 months.
- Who have reasonable expectations of surgery results.
- Who have areas of the lung that can be targeted.
- Who have severe difficulty breathing, as determined by breathing tests.
What are the complications and side effects?
While effective for some patients, there are risks involved with lung reduction surgery, including:
- Air leakage (occurring when air leaks from the lung tissue, coming from the suture line into the chest cavity)
- Pneumonia or infection
- Heart attack
- Death (due to worsening of one of the above complications)
It is important you understand the precautions and know the possible complication and side effects before having this Lung Volume Reduction Surgery (LVRS). If you have any questions, please consult with your doctor or surgeon for more information.
How do I prepare for Lung Volume Reduction Surgery (LVRS)?
Your doctor will give you specific instructions on how to prepare for lung volume reduction surgery. In general, you are supposed to quit smoking at least six months before surgery and keep your weight within a healthy range. This means a BMI ≤31.1 (males) and a BMI ≤32.3 (females).
What happens during Lung Volume Reduction Surgery (LVRS)?
The goal of LVRS is to remove up to 30 percent of each lung, making the lungs smaller and allowing them to function better. Lung volume reduction surgery can be performed by either a sternotomy or with a minimally invasive technique called thoracoscopy. Your surgeon will carefully evaluate you to determine the safest surgical approach to treat your medical condition.
- Sternotomy: The median sternotomy involves cutting through the breastbone to open the chest. Both lungs (a bilateral approach) are reduced at the same time in this procedure.
- Thoracoscopy: A minimally-invasive technique, the thoracoscopy requires 3 to 5 small incisions made on both sides of the chest, between the ribs. A videoscope is inserted through one of the incisions to allow the surgeon to see the lungs. A stapler and grasper are inserted in the other incisions and are used to remove the most damaged areas of the lung. The stapler is used to reseal the remaining lung.
Thoracoscopy can be used to operate on either one (unilateral) or both lungs (bilateral) and allows the surgeon to assess and resect (cut out) any part of the lungs.
What happens after Lung Volume Reduction Surgery (LVRS)?
You should expect to stay in the hospital for 5 to 10 days after lung reduction surgery. Pulmonary rehabilitation usually begins within the first 4 to 6 weeks after surgery, and is a very important part of your recovery.
If you have any questions or concerns, please consult with your doctor or surgeon for more information.
What should you do after Lung Volume Reduction Surgery (LVRS)?
Improvement in breathing is generally noticed within six to eight weeks following the operation. This improvement is ongoing as you continue your exercise program. Exercise is very important in helping to regain your physical strength and retraining your chest wall muscles to work. It is important to understand that not all patients have improved breathing after the surgery.
The goal of the surgery is not to eliminate the need for supplemental oxygen. In fact, it is very unlikely that lung volume reduction surgery will allow a patient to remain off supplemental oxygen post-operatively.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Lung volume reduction surgery. https://www.mayoclinic.org/tests-procedures/lung-volume-reduction-surgery/about/pac-20385045. Accessed October 19, 2018.
What Are the Treatments for Emphysema? https://www.webmd.com/lung/copd/treatment-for-emphysema#1. Accessed October 19, 2018.
Lung Volume Reduction Surgery. https://www.uofmhealth.org/conditions-treatments/pulmonary/lung-volume-reduction-surgery. Accessed October 19, 2018.
Lung Volume Reduction Surgery (LVRS). https://my.clevelandclinic.org/health/treatments/13794-lung-volume-reduction-surgery-lvrs. Accessed October 19, 2018.
COPD: Lung Volume Reduction Surgery. https://www.healthlinkbc.ca/health-topics/hw258376. Accessed October 19, 2018.
Review Date: November 12, 2018 | Last Modified: September 13, 2019