CHAPTER 26 Lung Volume Reduction Surgery—Video 26
Introduction
Compared with maximal medical management, lung volume reduction surgery (LVRS) has improved quality of life, pulmonary function, exercise tolerance, and survival for selected patients.1 Although LVRS can be performed as video-assisted thoracic surgery (VATS) or a median sternotomy with the same morbidity, mortality, and benefits, the VATS approach costs less and provides earlier recovery.2
Approach to Video-Assisted Lung Volume Reduction Surgery
Order of Operative Steps
Video-assisted LVRS is performed most commonly as a staged, bilateral procedure with the patient in the lateral decubitus position. Unless there is a massive air leak after the first side is completed, the patient is turned over for LVRS on the opposite side. The area to be resected is determined by the preoperative workup. The preoperative CT and perfusion scans to determine the area to be resected (usually the upper lobes). These areas do not deflate well intraoperatively because of poor elastic recoil.
Key Points
Video-Assisted Lung Volume Reduction Surgery (Video 26)
Step 1. Incisions

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