Pre-operative Pulmonary Surgery Services for Preparation for LVRS (G0303)

Name of the Procedure:

• Common Name: Pre-operative Pulmonary Rehabilitation
• Technical/Medical Terms: Pre-operative Pulmonary Surgery Services for Lung Volume Reduction Surgery Preparation

Summary

Pre-operative pulmonary rehabilitation involves a structured program to improve lung function and overall fitness before undergoing lung volume reduction surgery (LVRS). This program typically spans 10 to 15 days and prepares patients physically and mentally for the surgical procedure.

Purpose

Medical Conditions or Problems Addressed:

• Chronic Obstructive Pulmonary Disease (COPD)
• Emphysema

Goals or Expected Outcomes:

• Enhance lung function
• Increase exercise capacity
• Improve overall physical health
• Optimize conditions for a successful surgery

Indications

Specific Symptoms or Conditions:

• Severe COPD or emphysema not adequately managed by medication

Patient Criteria:

• Patients evaluated and identified as suitable candidates for LVRS
• Patients requiring optimization of their health status prior to surgery

Preparation

Pre-procedure Instructions:

• Maintain a nutritious diet
• Avoid smoking or exposure to lung irritants
• Adjust medications as directed by the healthcare provider

Diagnostic Tests or Assessments:

• Pulmonary function tests
• Exercise capacity assessments
• Comprehensive medical evaluation

Procedure Description

Step-by-Step Explanation:

1. Initial Assessment: Conduct a thorough medical evaluation and baseline lung function tests.
2. Exercise Training: Supervised exercise sessions to improve endurance and strength.
3. Breathing Retraining: Techniques to enhance lung efficiency and reduce breathlessness.
4. Education: Informing patients about COPD management and post-surgical care.
5. Nutritional Counseling: Guidance on dietary adjustments to support lung health.
6. Psychological Support: Coping mechanisms and emotional support to manage anxiety related to surgery.

Tools, Equipment, or Technology:

• Treadmills or stationary bikes
• Pulmonary function testing equipment
• Educational materials and resources

Anesthesia or Sedation:

• Not applicable for this pre-operative program

Duration

• Typically spans 10 to 15 days

Setting

• Outpatient pulmonary rehabilitation clinic or hospital-based rehabilitation center

Personnel

• Pulmonologists
• Respiratory therapists
• Physical therapists
• Nurses
• Dietitians
• Psychologists

Risks and Complications

Common Risks:

• Muscle soreness or fatigue from exercise
• Breathlessness during initial sessions

Rare Risks and Complications:

• Adverse reactions to exertion
• Increased anxiety (managed with psychological support)

Benefits

Expected Benefits:

• Improved lung function and exercise capacity
• Better overall health leading to a reduced risk of surgical complications
• Enhanced recovery post-surgery

Timeframe for Realization:

• Benefits generally observed within the span of the program and continue to improve post-surgery

Recovery

Post-procedure Care:

• Continual practice of exercises and breathing techniques at home
• Regular follow-up visits to monitor progress

Expected Recovery Time:

• Immediate benefits during the program; ongoing improvement expected after surgery

Restrictions and Follow-Up:

• Monitor exertion levels to avoid overexertion
• Adhere to follow-up schedules for post-surgical assessments

Alternatives

Other Treatment Options:

• Medication management
• Regular pulmonary rehabilitation (non-surgical preparation)
• Lung transplantation

Pros and Cons:

• Medication Management: Less invasive but may not be effective for severe cases.
• Regular Pulmonary Rehabilitation: Beneficial but might not sufficiently prepare for surgery.
• Lung Transplantation: Suitable for end-stage disease but involves higher risk and longer recovery.

Patient Experience

During the Procedure:

• Initial discomfort or breathlessness during exercise
• Gradual improvement in symptoms and physical capability

After the Procedure:

• Improved confidence and physical fitness
• Reduced anxiety about surgery
• Pain and discomfort managed with prescribed pain relief and comfort measures

Pain management strategies and patient support aim to ensure comfort and address any issues promptly, ensuring a positive overall experience.