What tests are needed to determine if lung volume reduction surgery is needed?

Your physician can determine if LVRS is an appropriate treatment for you by performing the following tests:

  • Chest x-ray
  • Pulmonary function tests
  • Arterial blood gas (to measure levels of carbon dioxide and oxygen in the blood)
  • Electrocardiogram (EKG)
  • High-resolution computed tomography scan
  • Oxygen titration
  • Six-minute walk
  • Cardiopulmonary exercise test
  • Right heart catheterization (only if additional tests are required)
  • Cardiac stress test
  • Pulmonologist consultation

How is lung volume reduction surgery completed?

The goal of LVRS is to remove up to 30 percent of each lung, making the lungs smaller and allowing them to function better. Lung volume reduction surgery can be performed by either a sternotomy or with a minimally invasive technique called thoracoscopy. Your surgeon will carefully evaluate you to determine the safest surgical approach to treat your medical condition.

  • Sternotomy: The median sternotomy involves cutting through the breastbone to open the chest. Both lungs (a bilateral approach) are reduced at the same time in this procedure.
  • Thoracoscopy: A minimally-invasive technique, the thoracoscopy requires 3 to 5 small incisions made on both sides of the chest, between the ribs. A videoscope is inserted through one of the incisions to allow the surgeon to see the lungs. A stapler and grasper are inserted in the other incisions and are used to remove the most damaged areas of the lung. The stapler is used to reseal the remaining lung.

Thoracoscopy can be used to operate on either one (unilateral) or both lungs (bilateral) and allows the surgeon to assess and resect (cut out) any part of the lungs.

Last reviewed by a Cleveland Clinic medical professional on 07/17/2019.


  • Fishman A, et al. National Emphysema Treatment Trial Research Group. A randomized trial comparing lung-volume-reduction surgery with medical therapy for severe emphysema. N Engl J Med. 2003 May 22;348(21):2059-73.
  • American Lung Association. Lung Health & Diseases—Surgery. Accessed 7/15/2018.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy