Guide to Lung Volume Reduction Surgery

Lung volume reduction surgery (LVRS) is a surgical procedure in which sections of severely damaged lung tissue are removed.

Key info

  • Lung Volume Reduction Surgery (LVRS) is a surgical treatment for end-stage chronic obstructive pulmonary disease, or COPD.
  • LVRS involves removing diseased portions of the lung so that the healthy lung can function more efficiently.
  • LVRS is performed with a minimally invasive technique and improves quality of life and exercise capacity.

By removing the most diseased tissue (up to 30% of the lung volume), the goal is to improve the residual lung function and respiratory mechanics in those with end-stage emphysema.

LVRS is performed through a video-assisted minimally invasive technique. Studies show LVRS significantly improves quality of life, increases exercise capacity and even improves survival in carefully selected cases.

Who is a Candidate for LVRS?

Estimates suggest that 12 million Americans suffer have been diagnosed with chronic obstructive pulmonary disease (COPD). However, around 12 million more Americans likely have COPD, but have not yet been diagnosed. COPD is the third leading cause of death in the United States, claiming more than 120,000 lives each year (NIH). Most people successfully manage their COPD with a combination of appropriate medical therapy, such as medication, and exercise. However in those with end stage emphysema/COPD, these conservative treatments may no longer be sufficient, and LVRS may be recommended. Studies have shown that LVRS significantly improves quality of life, increases exercise capacity and even improves survival among those that are good candidates for the surgery.

Bronchoscopic Lung Volume Reduction (bLVR)

In certain cases, an alternate technique called bronchoscopic lung volume reduction (bLVR) may be an option. bLVR is performed using a flexible bronchoscope and placing endobronchial valves in diseased tissue. These valves allow air to leave, but not enter, the affected or diseased parts of the lung.

LVRS Course of Treatment

LVRS is indicated for those with severe bilateral emphysema and hyperinflation, with disease located predominantly in the upper lobes of the lung. Treatment is made up of the following stages:

  • Treatment commences with a six-week program of outpatient pulmonary rehabilitation, accompanied by intensive follow-up.
  • Diagnostic tests are performed for heart function.
  • Surgery is performed, utilizing video-assisted, minimally invasive techniques in nearly all cases.
  • Pulmonary rehabilitation begins.

For people that are not candidates for LVRS, a lung transplant could be recommended.

Next Steps

If you need help for a lung or chest issue, we’re here for you. Call (212) 305-5501 or email lvrscolumbia@cumc.columbia.edu to make an appointment with one of our specialists.

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