Thoracic Surgery Division

Lung Volume Reduction Surgery (LVRS)

Background Information on LVRS | What to Expect Before, During and After Surgery | Patient Evaluation, Testing, etc.

What to Expect Before, During and After Lung Volume Reduction Surgery

Pre-operative Instructions for Patients

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You should NOT have anything to eat or drink after midnight the night before surgery. You may also be given additional instructions.
You should review all of your current medications with the surgeon or anesthesiologist to receive instructions on when and how to take these on the day of surgery.
You should NOT take any nonsteriodal anti-inflammatory drugs (such as aspirin, ibuprofen, Indocin, Naprosyn, Daypro, Voltaren, Feldene, Clinoril or Plavix) for at least 7 days prior to surgery.
You should NOT take any Coumadin for at least 4 days prior to surgery. A blood test will be needed the day before and the morning of surgery.
You should be off of Lovenox for 24 hours prior to surgery, unless you have been instructed differently by your surgeon.
Notify your surgeon, nurse or anesthesiologist if you have taken any steroids (such as prednisone or hydrocortisone) in the past 6 months
Bring a list of your current medications with you on the day of surgery.
Bring a copy of your Advance Directive or Living Will, if you have one.
Leave all valuables at home.
Call our office promptly at 410-328-6366 if you have any problems before or after surgery. (for example: report cold symptoms, fever, and unusual pain). Our phone is always answered, either by our regular staff or by our answering service.
Remember to pack your exercise shoes, socks, pants and shirt for your pulmonary rehabilitation!

SURGERY DAY

Arrival Directions

Patients will need to arrive in Ambulatory Surgical Care Unit (ASCU) on the date of your surgery. The patient will be notified the day prior to surgery by our office with a time to arrive. The ASCU is located on the 2^nd Floor D Wing South Hospital in the Weinberg Building at the University of Maryland Medical Center in Baltimore, MD. From the main hospital entrance on Greene Street, turn left and walk through the main lobby of the North Hospital. Turn Right at the M&T Bank and proceed to the elevator rotunda in the South Hospital. Take the South Hospital elevators to the 2^nd Floor and follow the signs to the Ambulatory Surgical Care Unit located on the 2^nd Floor D Wing South Hospital.

Patients are generally asked to arrive by 6:00 – 6:30 a.m. the morning of surgery in order to allow for the anesthesia prep (this includes IV’s, epidural catheter placement, assessment, etc.) to proceed promptly and not delay the surgery.

Family Waiting Information

All family members should wait on the 7^th Floor of the Gudelsky Building while the patient is in surgery. Family will be directed to this area and will wait here for the surgeon for updates, unless another waiting area is specified. The operation takes approximately 4 to 5 hours from start to finish, although the operating time is only 2-3 hours.

Surgery -- What to Expect

In the ASCU, the patient will be “prepped” for surgery, which will include the placement of IV’s and an epidural catheter by anesthesia.
An operating room nurse will meet the patient outside the operating room and bring the patient into the room.
An anesthesiologist will meet the patient inside the operating room. They will place the patient on a heart monitor and oxygen saturation monitor. They will then give the patient medication to make the patient sleepy. All other procedures will take place after the patient is asleep.
Tubes & Catheters -- One large IV will be placed in the patient’s neck. A special catheter will go through this IV to monitor the heart very carefully. A catheter will be placed in the patient’s bladder to drain urine. A tube will be placed in the patient’s mouth down to the patient’s lungs to assist in breathing during the operation. This tube will be removed after the surgery is complete and usually before the patient is fully awake.
The patient will recover in the Cardiothoracic Intensive Care Unit (CTICU) on the 7th floor in the Gudelsky building. The nurses are specially trained to care for patients emerging from anesthesia and who have had Lung Volume Reduction. They will ask the patient many times about their breathing and pain level while the patient is emerging from anesthesia. The patient’s family can visit the patient after the patient is settled into the CTICU.

Discharge Instructions

The nurse will review a set of discharge instructions at the time of discharge. This will include medications, diet, activity and follow-up instructions. Patients who are being discharged are required to have a responsible adult available to provide them with transportation home.

Follow-up Appointment

Please contact the Thoracic Surgery Office at 410-328-6366 to schedule a follow-up appointment with the surgeon once the patient arrives home. This visit is typically 2-4 weeks after surgery depending on the patient’s specific needs.

Questions

We want you and your family to be comfortable with your care and surgery.

If you or your family have any questions about surgery or while you are in the hospital, please feel free to call your physician, nurse coordinator or nurse practitioner.

Contact Phone Numbers
Thoracic Surgery Office – Physicians or appointment scheduling	410-328-6366
Thoracic Surgery Nurse Practitioner	410-328-5534
Thoracic Surgery Nurse Coordinator	410-328-6883
CTICU	410-328-5382
6 Gudelsky	410-328-5380

Our goal in the Division of Thoracic Surgery is to make your surgical experience free of worry and as comfortable as possible. If you should have any questions or concerns regarding surgery, please do not hesitate to contact our office at 410-328-6366.

This page was last updated on: May 14, 2008.

For more information or to schedule a consultation in our clinic, please contact us at 410-328-6366 or fax 410-328-0693.