Lung Volume Reduction Surgery for COPD

Lung volume reduction surgery (LVRS) is major surgery that reduces the volume, or size, of your lungs. Even though they’re smaller after the surgery, your lungs often work better.

It might help you breathe better if you have severe COPD that’s damaged your lungs. It’s done in the hospital by a thoracic surgeon to remove diseased lung tissue.

Why Is This Surgery Done?

Severe COPD can damage tissue inside your lungs. Every time you breathe, your lungs overinflate. You may have very severe shortness of breath. Air gets trapped in your lungs instead of moving in and out in a healthy, normal way.

Removing diseased tissue lets the healthy parts of your lung work better. You can breathe more easily. Your diaphragm, a muscle that you use when you breathe in and out, works better once the damaged tissue is gone.

Lung volume reduction surgery can help you:

  • Breathe more easily and effectively
  • Improve your quality of life
  • Allow you to get more exercise
  • Live longer

This surgery isn’t right for everyone with advanced COPD. But it may be an option if COPD has caused complications like:

  • Severe emphysema, or shortness of breath and damaged air sacs, in both lungs
  • Diseased tissue in the upper parts, or lobes, of both lungs
  • Less ability to exercise even after you complete pulmonary rehabilitation therapy

LVRS is also better for people with COPD who are younger than 75 to 80 and haven’t smoked for at least 6 months.

What Happens Before Lung Volume Reduction?

Before you have surgery, you’ll need some or all of these tests to check your heart and lung health:

  • Chest X-ray or CT scan
  • Pulmonary function test to check your lung health
  • Six-minute walk test
  • Cardiopulmonary exercise test on a treadmill or stationary bike
  • Electrocardiogram (EKG)
  • Arterial blood gas to measure carbon dioxide and oxygen levels in your blood
  • Oxygen titration test

Both your pulmonologist (a doctor with specialized training in lung diseases like COPD) and your surgeon will go over your test results to see if lung volume reduction is the right treatment for you.

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What Happens During Lung Volume Reduction Surgery?

Your surgeon will remove small, wedge-shaped pieces of damaged lung tissue during LVRS. Usually, about 20%-30% of each lung is removed.

The procedure is done in the hospital under general anesthesia. You’ll be completely “asleep” during the surgery.

This surgery can be done in three ways:

  • Sternotomy: This is more invasive. It’s also called median sternotomy. The surgeon cuts through your sternum, or breastbone, to open your chest. This lets him operate on both lungs at the same time.
  • Thoracotomy: The surgeon makes cuts between your ribs on either side of your chest. He spreads your ribs a little so he can get into your lungs and remove the diseased tissue.
  • Thoracoscopy: Your surgeon makes three to five tiny cuts around your chest. He inserts a thin, tube-shaped scope with a camera into one of the cuts so he can see inside your lungs. Then, he inserts tools into the other cuts to remove diseased lung tissue. When he’s done, he stitches the remaining healthy lung tissue so it seals up.

You’ll spend between 5 and 10 days in the hospital after any of these surgeries to recover.

What Happens After Lung Volume Reduction?

About 4 to 6 weeks after your surgery, you’ll start pulmonary rehabilitation therapy. In this series of sessions with a therapist, you’ll learn ways to improve your breathing, strength, outlook, and stamina so you can enjoy a better quality of life with COPD.

What Are the Risks of Lung Volume Reduction?

After LVRS, the most common risk is that you get air leaks in your lungs. That’s where air slips out of your lungs into your chest cavity as you breathe. Your surgeon can put in a chest tube to help the air drain outside your body until the leak heals, which usually takes a week. If you continue to have air leaks after LVRS, you may need a second surgery to fix them.

Other possible risks of LVRS include:

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What Are the Benefits of Lung Volume Reduction?

LVRS has many benefits. After surgery and rehab, you may be able to exercise more, have stronger lungs, and enjoy a better quality of life.

WebMD Medical Reference Reviewed by Paul Boyce, MD on August 19, 2019

Sources

SOURCES:

American Lung Association: “Lung Volume Reduction Surgery.”

Mayo Clinic: “Lung Volume Reduction Surgery.”

Cleveland Clinic: “Lung Volume Reduction Surgery (LVRS).”

Columbia Surgery: “General Thoracic Surgery Section: Lung Volume Reduction Surgery.”

National Heart, Lung, and Blood Institute: “Pulmonary Rehabilitation.”

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