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(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. This 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 possible problems, like:

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

Some factors will increase your risk of problems. Talk to your doctor about these factors, 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:

  • Stop smoking. Talk to your doctor about how you can quit.
  • Arrange for a ride home.
  • Arrange for help at home while you recover.
  • Do not eat or drink anything after midnight the night before surgery.

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. This includes over the counter medicine and supplements.

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.

Tubes will be place near the area. It will allow trapped air to pass out of your chest. This will help the lungs 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. The chest can be very painful after this type of surgery. Discomfort can last for a few weeks. Medicine will help to manage pain. You will also be shown steps like hugging a pillow to your chest.

Post-procedure Care

At the Care Center

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.

Call Your Doctor

Contact your doctor if your recovery is not progressing as expected or you develop complications, such as:

  • Difficulty breathing or cough
  • New pain in the chest or persistent and severe pain in the area of surgery
  • Stitches or staples that come apart
  • Excessive bleeding at the site of the incision
  • Coughing up mucus that is yellow, green, or bloody
  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision site
  • Severe nausea or vomiting

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

RESOURCES

American Thoracic Society  http://patients.thoracic.org 

The Society of Thoracic Surgeons  http://www.sts.org 

CANADIAN RESOURCES

Canadian Society for Vascular Surgery  http://canadianvascular.ca 

The Lung Association  http://www.lung.ca 

References

COPD. EBSCO DynaMed website. Available at: https://www.dynamed.com/topics/dmp~AN~T115557/COPD. Updated March 20, 2019. Accessed May 6, 2019.

Emphysema: lung volume reduction surgery. EBSCO Nursing Reference Center website. Available at: https://www.ebscohost.com/nursing/products/nursing-reference-center. Updated October 19, 2018. Accessed May 6, 2019.

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. Updated March 13, 2018. Accessed May 6, 2019.

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. Updated November 15, 2016. Accessed May 6, 2019.

Revision Information

  • Reviewer: EBSCO Medical Review Board
  • Review Date: 05/2019
  • Update Date: 05/21/2019