Lung volume reduction surgery

Lung volume reduction surgery (LVRS) is a procedure to help you breathe better when you have severe lung damage from emphysema, a type of chronic obstructive pulmonary disease (COPD). In emphysema, air sacs in your lungs are damaged and blocked, which traps air, overinflates your lungs, and moves less oxygen to your blood. LVRS removes damaged tissue to improve your lung function and put less pressure on your diaphragm, allowing you to breathe more comfortably.

Penn Medicine has a team of specialists who can evaluate you and determine if LVRS is right for you. Our surgeons have extensive experience performing lung volume reduction procedures and use the latest techniques for the best outcomes. Reduced lung volume doesn’t cure emphysema, but it can significantly improve your symptoms and help you stay active.

LVRS isn’t appropriate for everyone with COPD, but you might need this surgery if:

• You have severe emphysema that makes it hard to breathe.
• Lung damage affects your upper lungs.
• You’re younger than 75.
• You haven’t smoked for at least six months.
• Medications and pulmonary rehabilitation haven’t improved your symptoms.

You’ll need several tests before having this procedure, which may include pulmonary function tests, a computed tomography (CT) scan of your lungs, an electrocardiogram (ECG), an echocardiogram, and a cardiopulmonary exercise test. Your health care team will also give you instructions on how to prepare for the surgery. You may need to stop taking certain medications, and you’ll need to fast for a certain number of hours before your procedure.

There are a few approaches your surgeon might use during LVRS to access your lungs, including making a cut in the middle of your chest or using more than one incision between your ribs. Or your surgeon might make small incisions on each side of your chest and use a thin tube with a tiny lighted camera as a guide to reach your lungs.

During surgery:

• You’ll be given general anesthesia to put you to sleep, and you’ll be put on a breathing machine.
• Your surgeon will make one or more incisions depending on which approach is being used.
• Using surgical tools, your surgeon will remove about a third of your lungs and seal them shut.
• Tubes will then be placed to drain fluid from your lungs.
• The incisions will be closed and covered with a surgical dressing.

You’ll stay in the hospital for several days after your procedure. Some people will need to be on a breathing machine for a couple of days. Within about a month of surgery, you’ll need pulmonary rehabilitation.

Risks can include an infection, like pneumonia, a blood clot, or air leaking from where your lung was closed, although most air leaks heal on their own within about a week. In rare cases, more serious risks, like lung collapse or heart problems, may occur. Talk to your doctor if you have questions about risks associated with this surgery.

It takes the expertise of specialists from a variety of disciplines to assess your lung disease, determine if lung volume reduction is appropriate, and plan the most effective treatment strategy. At Penn Medicine, a team of experts from pulmonology, thoracic surgery, and other specialties consider your condition and recommend the best treatment course for you.

Our providers have vast experience performing LVRS and other procedures to reduce lung volume, including a minimally invasive approach that doesn’t require incisions called bronchoscopic lung volume reduction, also known as endobronchial valve placement. We also have a care team that guides you through your pulmonary rehabilitation exercises, supporting your recovery and helping you breathe easier