Lung volume reduction surgery (LVRS) is an innovative surgical treatment for select patients with severe emphysema, one of several respiratory disorders labeled as chronic obstructive pulmonary disease (COPD). NewYork-Presbyterian/Columbia University Medical Center is the only New York City-area hospital – and one of only 17 centers nationwide – to be selected by the Centers for Medicare & Medicaid Services (CMS) to perform the procedure after having participated in the National Emphysema Treatment Trial (NETT). NETT demonstrated that the procedure improves the quality of life for certain emphysema patients.
The goal of LVRS is to remove the worst areas of damaged lung tissue so that the remaining tissue can function better. This surgery can be performed using an open surgical approach (cutting through the breast bone to open the chest) or by a minimally invasive, video-assisted thoracic procedure. This method uses 3-5 small incisions to allow the surgeon to insert specially designed instruments between the ribs and into the chest. With either method, 25-30% of the most damage regions of the lung volume are removed. Scientists believe that by surgically removing functionally useless tissue, air will move in and out of the remaining lung more readily, thereby easing symptoms associated with advanced emphysema and improving overall lung function.
NewYork-Presbyterian/Columbia will follow Medicare guidelines, which limit the procedure to those who have severe emphysema in the upper lobes of their lungs, and those who have severe disease elsewhere in the lungs and a poor ability to exercise. Medicare also requires that patients be further screened through testing and undergo extensive exercise and education programs to improve lung function both before and after surgery.
If you are interested in being evaluated for possible lung volume reduction surgery, you should call the Center for Chest Disease to obtain a patient questionnaire. Your primary care physician will be asked to provide your medical history - including any pulmonary function studies and x-rays. The staff at the Center will review your medical history. Candidates for whom LVRS is appropriate will be contacted to arrange for further testing. All patients, whether surgical candidates or not, are evaluated for and prescribed a pulmonary rehabilitation program during their evaluation at the Center. Insurance coverage for lung volume reduction surgery is determined by the patient's insurance plan. Most private insurance plans cover the procedure; Medicare covers lung volume reduction surgery with condition. Financial counselors at the Center help our patients to determine whether their insurance covers any or all costs.