Thoracic Surgery Division

Lung Volume Reduction Surgery (LVRS)

Lung Volume Reduction Surgery (LVRS) | Evaluation and Testing | What to Expect

What to Expect

Pre-operative Instructions

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You should NOT have anything to eat or drink after midnight the night before surgery. Additional instructions may also apply.
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 seven days prior to surgery.
You should NOT take any Coumadin for at least four 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 six 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, to report cold symptoms, fever, and unusual pain). Our phone is always answered by our regular staff or 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 their surgery. Patients will be notified the day prior to surgery 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 M&T Bank and proceed to the elevator rotunda in the South Hospital. Take the South Hospital elevators to the second floor and follow the signs to the Ambulatory Surgical Care Unit.

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

Family Waiting Information

All family members should wait on the seventh 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 four to five hours from start to finish, although the operating time is only two to three hours.

The Surgery

In the ASCU, the patient will be “prepped” for surgery, which will include the placement of IVs 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. He or she will place the patient on a heart monitor and oxygen saturation monitor. He or she will then give the patient medication to make the patient sleepy. All other procedures will take place after the patient is asleep.
Tubes and Catheters -- Chest tubes are used for drainage and to monitor air leakage. Chest tubes are placed at the time of surgery. The chest tube is hooked up to a container and water chamber. It will remain in until the drainage stops and there is no air leaking. Occasionally, chest tubes are left in after discharge from the hospital and are removed in a subsequent office visit. In addition, 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.
Pain Control -- Operations create pain. At the University of Maryland Medical Center, we make every effort to minimize your discomfort through IV medications and epidural catheters. An epidural catheter is a very small tube placed in your back at the time of surgery. Pain medication is infused through the catheter that will bathe the spinal cord and prevent pain. You will feel discomfort from the chest tube, but the pain will be managed through the catheter. You will be asked frequently about your pain. Please be honest. It is very important for the pain to be under control because taking deep breaths and moving are essential for quick recovery.
The patient will recover in the Cardiothoracic Intensive Care Unit (CTICU) on the seventh floor in the Gudelsky building. The nurses are specially trained to care for patients emerging from anesthesia 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 two to four 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, 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: June 8, 2010.

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