Name of the Procedure:

Pre-operative Pulmonary Surgery Services for Preparation for Lung Volume Reduction Surgery (LVRS)
Common Names: Pre-op Pulmonary Rehab for LVRS, Pre-op Respiratory Therapy for LVRS

Summary

This is a comprehensive medical service that prepares patients with severe lung disease, like emphysema, for Lung Volume Reduction Surgery (LVRS). It involves a complete course of pulmonary rehabilitation services spanning at least 16 days to optimize the patient's health and boost the success rate of the surgery.

Purpose

This series of services aims to improve lung function and overall physical conditioning, making the patient more fit for surgery. The goal is to enhance respiratory capacity, reduce symptoms like breathlessness, and improve overall quality of life.

Indications

• Patients diagnosed with severe emphysema or other debilitating lung diseases.
• Those who are candidates for Lung Volume Reduction Surgery (LVRS).
• Patients experiencing significant lung function impairment, such as reduced ability to exercise or perform daily activities due to shortness of breath.

Preparation

• Patients should undergo a complete medical evaluation including cardiopulmonary tests (e.g., spirometry, blood gas analysis).
• Tailored exercise programs and nutritional guidance.
• Instructions on medication adjustments, if necessary.
• Smoking cessation if the patient is a smoker.

Procedure Description

1. Initial Assessment: Comprehensive evaluation of lung function and physical condition.
2. Exercise Training: Supervised exercise sessions to improve endurance and strength.
3. Breathing Techniques: Instruction in specific techniques to improve lung efficiency.
4. Nutritional Counseling: Guidance on diet to support physical conditioning and lung health.
5. Education Sessions: Information on managing symptoms and maintaining respiratory health.
6. Psychosocial Support: Counseling to address anxiety, depression, or other emotional concerns related to lung disease and surgery.

Tools & Equipment: Treadmills, stationary bicycles, resistance training equipment, spirometers, pulse oximeters.

Anesthesia or Sedation: Not applicable.

Duration

• The complete course spans a minimum of 16 days, typically spread over several weeks.

Setting

• Outpatient rehabilitation center or specialized medical clinic.

Personnel

• Pulmonologists, respiratory therapists, physical therapists, exercise physiologists, dietitians, and psychologists.

Risks and Complications

• Generally low risk, but potential complications could include muscle soreness, fatigue, or respiratory discomfort. Managing these involves adjusting the exercise intensity and providing proper rest and recovery periods.

Benefits

• Improved lung function and physical fitness.
• Reduced symptoms like breathlessness.
• Increased likelihood of successful outcome from the subsequent LVRS.
• Enhanced quality of life post-surgery.

Recovery

• Post-procedure care includes ongoing exercise and breathing programs.
• Patients will receive guidelines for maintaining improvements and long-term health.
• Regular follow-up appointments to monitor progress.

Alternatives

• Medical management with medications and lifestyle changes without pulmonary rehabilitation.
• In some cases, considering other surgical options or treatments such as lung transplantation.
• Pros of alternatives: Less intensive, may be easier to adhere to for some patients.
• Cons of alternatives: May not improve surgical outcomes as effectively as pre-op pulmonary rehabilitation.

Patient Experience

• Patients might initially feel breathless or fatigued but will experience gradual improvement in lung capacity and physical fitness.
• Pain management includes supervised exercise with proper warm-up and cool-down techniques.
• Comfort measures such as adequate hydration, balanced nutrition, and supportive counseling help in managing the overall experience.