Lung volume reduction surgery is used to improve breathing in some people with severe emphysema, a type of chronic obstructive pulmonary disease (COPD). During surgery, small wedges of damaged lung tissue are removed to allow the remaining tissue to function better. There is a fairly rigorous process to qualify as a candidate for the surgery. After surgery, people often have less shortness of breath and are better able to exercise.

About lung volume reduction surgery

Evaluation

Mayo Clinic follows a careful process in evaluating treatment options for a person with advanced, severe emphysema. An immediate goal is to determine whether you might benefit from lung volume reduction surgery. But the evaluation is also an opportunity to optimize all aspects of care critical to good quality of life for someone with emphysema, including physical activity, stress reduction, medications, oxygen requirements, smoking cessation or anything else identified by your team of doctors and therapists.

Your evaluation at Mayo will include:

  • An extensive clinical, imaging and physiological evaluation, including, prior to surgery, tests of your heart and lung function, CT scan of your lungs to assess the severity and location of the emphysema, and exercise tests
  • Confirmation of the type of advanced emphysema that benefits most from surgery
  • Initiation of the process of pulmonary rehabilitation, a program that empowers people to take care of themselves and is customized to include any topic relevant to your situation

Surgery

During lung volume reduction surgery, a chest (thoracic) surgeon removes small wedges of damaged lung tissue, usually about 20 to 30 percent of each lung, to allow the remaining tissue to function better. As a result, the diaphragm contracts and relaxes more effectively and efficiently, so you can breathe more easily. Mayo Clinic surgeons are experienced in performing this surgery either via a large incision (thoracotomy) or through several small incisions using a special scope (video-assisted thoracoscopic surgery).

Aftercare

Once you are discharged from the hospital, Mayo promotes the idea of rehabilitation as a lifelong process. This is a hallmark of the Mayo Clinic experience — creating an environment for you that will promote a healthy lifestyle. Mayo will continue to oversee your care through a rehabilitation center closer to your home. Mayo Clinic works with your hometown doctor to ensure your continuing care is well coordinated.

Improved outcomes

A number of studies have shown that lung volume reduction surgery improves exercise capacity, lung function and quality of life in select candidates when compared with people who were treated nonsurgically.

People who are born with an inherited form of emphysema, called alpha-1-antitrypsin deficiency-related emphysema, are likely to develop severe emphysema in their 30s and 40s. A lung transplant may be a better treatment option than lung volume reduction surgery for these individuals because of their age.

  • Experience. Mayo Clinic has been a pioneering center in translating lung volume reduction surgery from a research tool to part of everyday care of people with emphysema. Mayo Clinic was one of the participating centers in the multicenter national trial that evaluated the effectiveness and role of lung volume reduction surgery. The trial helped define who is most likely to benefit from the surgery.
  • Coordinated, comprehensive care. You are cared for by doctors, nurses and therapists who specialize in lung diseases and who work together in the same clinic and hospital unit.
  • Special expertise. Mayo Clinic has the testing and medical expertise to help decide which treatment option is appropriate for you. Mayo Clinic in Minnesota has a state-of-the-art pulmonary rehabilitation program, which is key to the success of lung volume reduction surgery.
  • Qualifying center. Lung volume reduction surgery qualifies for Medicare reimbursement, by virtue of Mayo Clinic's status as a Medicare-approved lung transplant center.
  • Research leader. Mayo Clinic has been continuously funded by the National Institutes of Health to identify and test lung rehabilitation options, and then to translate this knowledge to the best care for people with lung diseases.

Mayo Clinic in Rochester, Minn., ranks #1 for respiratory disorders in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Jacksonville, Fla., and Mayo Clinic in Scottsdale, Ariz., are ranked high performing for respiratory disorders by U.S. News & World Report.

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Lung volume reduction surgery is performed by specialists in cardiothoracic surgery, who work closely with doctors in pulmonary medicine and physical medicine and rehabilitation to care for individuals before and after surgery.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

Lung volume reduction surgery is performed by specialists in thoracic surgery, who work closely with doctors in pulmonary medicine and physical medicine and rehabilitation to evaluate and care for individuals. The Minnesota location also has a state-of-the-art pulmonary rehabilitation program to help you before and after surgery.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Mayo Clinic participated in the National Emphysema Treatment Trial, which evaluated lung volume reduction surgery and helped identify who is most likely to benefit from the surgery and defined characteristics that predict both negative and positive surgical outcomes.

Publications

See a list of publications on lung volume reduction surgery by Mayo Clinic doctors on PubMed, a service of the National Library of Medicine.

Jul. 13, 2010