Surgery for COPD

Reviewed by: HU Medical Review Board | Last reviewed: February 2022 | Last updated: March 2023

Surgery may be a treatment option for some people with chronic obstructive pulmonary disease (COPD). Surgery can help the lungs work better and improve quality of life. But surgery is only a choice for some people with COPD. Not everyone with COPD will benefit from it, and not everyone is a good candidate for surgery.1

There are 3 main types of surgery that may be used to treat COPD:1,2

Who might be a good candidate for surgery for COPD?

Surgery can help people with COPD breathe better. But not everyone is a good candidate. Doctors use many different tests to find out if surgery is a good option. A whole team of doctors might be involved in helping a person with COPD consider whether to have surgery. After tests and consultations, it will be up to the person with COPD and doctors to decide if surgery is the right treatment choice.1,2

COPD is primarily made of 2 conditions: chronic bronchitis and emphysema. Most people have symptoms of both conditions, which is why they are lumped under the same name. Bullectomy and LVRS only address the lung damage caused by emphysema.1,2

Different surgeries will have different requirements for someone to be a good candidate. However, some of the basic conditions are:1

  • You must be strong enough for surgery.
  • You cannot be a current smoker.
  • You need to have participated in a pulmonary rehabilitation program, which is a special educational program for people with COPD.

What is a bullectomy?

Healthy lungs have millions of tiny air sacs called alveoli. Emphysema damages the walls of the alveoli. When the alveoli walls are damaged, they start to form fewer large air spaces, instead of many tiny ones. These large air spaces are called bullae.1,3

Bullae can become large enough that they crowd out the healthier portions of the lungs. They also create less area in the lungs where oxygen can enter the bloodstream. During a bullectomy doctors remove 1 or more of the bullae.1,3

Removing the bullae helps the remaining parts of the lungs function better. The size and location of the bullae in a person's lungs determines whether this kind of surgery is an option.1,3

What is lung volume reduction surgery?

Lung volume reduction surgery (LVRS) may be another surgery option to address the lung damage caused by emphysema. The goal of a LVRS is to remove the most damaged sections of the lungs. The damaged sections are typically removed from the upper regions of the lungs.1,2

Removing the most damaged sections of the lungs can help the healthier parts of the lungs to work better. It can also reduce pressure on the diaphragm. The diaphragm is the main muscle that controls breathing. If pressure on the diaphragm is reduced, it can move more efficiently and make breathing easier.1,2

There is also a less invasive lung volume reduction surgery called bronchoscopic lung volume reduction that may be beneficial for some people living with COPD.

What is a lung transplant?

A lung transplant may be an option for people with serious lung damage who are otherwise healthy. During a lung transplant, 1 or both of a person's lungs are removed and replaced with healthy lungs from a donor.3,4

A lung transplant can make it much easier to breathe and be active. However, it is a major surgery that carries many risks. People and their doctors must carefully consider whether it is the right option.4

The number of people waiting for lung transplants is much higher than the number of available donor lungs. This means once a person decides to go forward with a lung transplant, they may have to wait a long time until a suitable donor organ becomes available. This waiting period can be very stressful.4

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