Lung Volume Reduction Surgery for Emphysema (LVRS)

Current medical treatments of emphysema provide a modest degree of palliation, but there is no medical therapy that dramatically improves emphysema patients' shortness of breath or improves their survival. However, lung volume reduction surgery (LVRS) may be a viable solution for qualifying patients. LVRS is a surgical treatment for emphysema that could dramatically improve symptoms and, in many cases, increase longevity. Read more about emphysema and LVRS, and watch a video in which Dr. Joseph B. Shrager speaks about emphysema and LVRS in detail. This newer surgical treatment that Dr. Shrager shares has substantially changed the way emphysema is in many cases treated.

Dr. Joseph B. Shrager has performed over 150 lung volume reduction surgeries (LVRS) with substantial improvement in shortness of breath and quality of life in nearly all patients and with a mortality rate of 0.67% (less than one-fifth of the mortality rate identified in the major published series of LVRS in appropriately selected patients).

Read the publication describing Dr. Shrager’s first 50 bilateral LVRS operations

Dr. Shrager will be glad to personally review the CT scans (not the report only) and PFTs of potential patients who are candidates for LVRS prior to scheduling a patient visit. This information can be mailed to:

Dr. Joseph Shrager
Department of Cardiothoracic Surgery
Falk Building
870 Quarry Rd
Palo Alto, CA 94304
Telephone: 650-721-2086  

He will review these materials to determine the patient's initial candidacy for the operation, then arrange a patient visit if he thinks it is likely that he can help the patient with LVRS.

For patients who are not good candidates for surgical LVRS, we have an ongoing clinical trial of using stereotactic radiotherapy (sometimes called "SABR" or "Cyberknife") to create lung volume reduction.  We are studying this therapy, termed "SAVR"(stereotactic ablative volume reduction)  to determine whether it can have the same or similar benefits as surgical LVRS.

Chest x-rays before and after LVRS

Typical areas of lung removed during LVRS

Incision placement for the thoracoscopic (VATS) approach to the operation

Intraoperative photo showing the stapling device used to remove the most abnormal, emphysematous lung tissue. 

If you would like to make an appointment to see one of our surgeons for any of these problems, please call (650) 498-6000 and ask for the Thoracic Surgery new patient coordinator, or call (650) 721-2086.

The Division of Thoracic Surgery in the Department of Cardiothoracic Surgery at the Stanford School of Medicine is located in the San Francisco Bay Area in northern California. For more information about our services, please contact Donna Yoshida at (650) 721-2086 or Angela Lee, RN, MS, at (650) 721-5402. For new patient Thoracic Surgery Clinic Scheduling, please call (650) 498-6000.