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Open Lung Volume Reduction Surgery

(LVRS-Open)

Definition

Lung volume reduction surgery (LVRS) removes areas of severe disease from both of your lungs. Open LVRS involves cutting through the chest to do the surgery.

Reasons for Procedure

LVRS is used to treat severe lung damage due to COPD. This damaged lung tissue is not able to do its job. LVRS removes this damaged tissue. The remaining lungs will have more room to expand. The diaphragm muscle, that helps your breathe, will also be able to work better. These changes will increase the amount of air the lungs can move and ease breathing.

Possible Complications

Potential problems are rare, but all procedures have some risk. Your doctor will review problems, like:

  • Air leaking from lung tissue
  • Pneumonia or infection
  • Excess bleeding
  • Adverse reaction to anesthesia
  • Blood clots
  • Stroke
  • Heart attack

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of problems, such as:

  • Smoking
  • Chronic diseases, such as diabetes or obesity

What to Expect

Prior to Procedure

Your doctor will review previous tests. This may include images of your lungs, heart, and blood tests.

Before surgery, you will need to:

  • Become a non-smoker. Talk to your doctor about how you can quit.
  • Arrange for a ride home.
  • Arrange for help at home while you recover.
  • Certain medicines may cause problems during the procedure or recovery. These medicines may need to be stopped up to one week before the procedure.
  • Talk to your doctor before the procedure about all medicines you are taking, including over the counter medicines and supplements.
  • Do not eat or drink anything after midnight the night before surgery.

Anesthesia

General anesthesia will be used. It will put you to sleep.

Description of Procedure

An incision will be made in the middle or side of your chest. The bone in the middle of your chest may be cut open to access your lungs. Small wedges of one or both lungs will be removed and closed off. Chest tubes will be left in place. It will allow trapped air to pass out of your chest and allow lungs to stay inflated. The bone in the chest will be closed with wire. The incision will be closed with sutures.

How Long Will It Take?

It will take up to 4 hours.

How Much Will It Hurt?

Anesthesia will prevent pain during the procedure. Pain after the procedure can be managed with medicine.

Post-procedure Care

At the Care Center

Right after the procedure, the staff may give you pain medicine.

You will be in the hospital for 5 to 10 days. Your breathing and lungs will be watched closely. Chest tubes may be removed.

At Home

A pulmonary rehab program is an important part of recovery. You will be taught exercises to help improve breathing.

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

Family Doctor—American Academy of Family Physicians
http://www.familydoctor.org

Ortho Info—American Academy of Orthopaedic Surgeons
https://orthoinfo.aaos.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://coa-aco.org

Canadian Orthopaedic Foundation
https://www.whenithurtstomove.org

REFERENCES:

COPD. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/copd. Accessed March 19, 2021.

Emphysema: lung volume reduction surgery. EBSCO Nursing Reference Center website. Available at: https://www.ebscohost.com/nursing/products/nursing-reference-center. Accessed March 19, 2021.

Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of COPD. GOLD 2019

Lung volume reduction surgery. American Lung Association website. Available at: https://www.lung.org/lung-health-and-diseases/lung-procedures-and-tests/lung-volume-reduction-surgery.html. Accessed March 19, 2021.

Lung volume reduction surgery (LVRS): procedure details. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/treatments/13794-lung-volume-reduction-surgery-lvrs/procedure-details. Accessed March 19, 2021.

Last reviewed March 2021 by EBSCO Medical Review Board