Understanding Lung Volume Reduction Surgery (LVRS)
Lung volume reduction surgery (LVRS) is one type of treatment for emphysema. Emphysema is a condition in which the air sacs in your lungs become damaged over time. You may then have trouble breathing. During LVRS, the surgeon removes the damaged part of the lung. This allows the rest of the lung to work better.
Emphysema is mainly caused by smoking cigarettes. It often occurs with chronic bronchitis, which causes a lasting cough and a buildup of mucus. These two conditions are also known as COPD (chronic obstructive pulmonary disease).
COPD is most often managed with medicines and other treatments. But the problem tends to get worse with time. If medicine and other treatments don't help enough, lung volume reduction surgery may be an option.
Why LVRS is done
Your doctor may recommend LVRS for your emphysema. LVRS can help make breathing easier. This helps you have a better quality of life.
LVRS isn’t for every person with COPD. The surgery may be an option for you if:
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You have lung damage, often in the upper part of the lung, especially if it's only in one part of the lung.
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You are younger than 75 to 80 years old.
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You have not smoked for at least 6 months.
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You can’t exercise well, even after going through pulmonary rehab.
A pulmonologist can help find out if surgery could help you. This is a doctor who focuses on lung health. They will do some tests, which may include:
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Pulmonary function tests.
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A 6-minute walk test.
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Arterial blood gas test.
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CT scans of the lungs.
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An electrocardiogram (ECG).
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An echocardiogram (echo).
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An exercise test.
If surgery is right for you, you will talk with a thoracic surgeon. This is the doctor who will do the surgery.
How LVRS is done
If tissue needs to be taken out from both lungs, you will have open surgery. The surgeon makes a cut (incision) in the center of your chest. They gently move apart the breastbone. The surgeon takes out the damaged lung tissue.
If tissue needs to be taken from only one lung, you will have a thoracoscopy. The surgeon makes 3 to 5 small cuts on both sides of your chest. They put tools through the cuts for the surgery. The surgeon then takes out the damaged lung tissue.
This surgery is done with general anesthesia. This means you are asleep so you don't feel pain. You will be on a breathing machine during the surgery.
After surgery, you will likely stay in the hospital for 5 to 10 days. You will then go home to finish your recovery. You may start pulmonary rehab about 4 to 6 weeks after surgery. This includes exercises and help with managing your condition. Rehab will help your lungs work better. It will improve your quality of life. Check with your insurance plan to find out if rehab is covered.
Risks of LVRS
The benefits of LVRS are better breathing and a better quality of life. But as with any surgery, there are risks. These include:
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No improvement after the surgery.
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Reactions to anesthesia.
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Air leakage from the lung stitches (sutures) into the chest cavity.
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A lung infection (pneumonia).
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A stroke or heart attack.
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Bleeding.
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Blood clots.
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Death from worsening health problems, including those listed above.