Has a healthcare provider talked with you about surgery as a possible treatment for chronic obstructive pulmonary disease (COPD)? If other treatments aren’t helping and your condition is getting worse, surgery might make you feel better.

However, surgery isn’t a good option for everyone with this lung disease. COPD procedures aren't very common because some people aren’t healthy enough for them. If you’re thinking about surgery for COPD, it’s important to make an informed decision. Keep reading to learn the basics about surgery for COPD.

What Surgeries Might Be Used for COPD?

A few main types of surgery may be considered for people living with severe COPD — volume reduction surgery (LVRS), bullectomy, and endobronchial valve therapy (EVT). These procedures are done only when other treatments haven’t helped and certain criteria are met (discussed below). These procedures usually involve minimally invasive techniques for faster healing and a lower risk of complications.

Lung Volume Reduction Surgery

LVRS specifically treats people with emphysema, a form of COPD. If you have this surgery, a team of doctors with different specialties will remove parts of your lung that aren’t working and your body isn’t using — usually between 20 percent and 35 percent of the diseased tissue. Removing this damaged tissue helps your diaphragm (main breathing muscle) work better, which makes breathing easier. Because LVRS reduces the size of your lungs, it’s sometimes called lung reduction surgery for COPD.

Bullectomy

In a bullectomy, doctors remove bullae — air pockets that form when parts of the lungs get damaged. These pockets can press on healthy lung tissue and reduce airflow. Bullectomy is an option only when the bullae take up more than a third of the lung’s space and are causing problems. Most people don’t have large enough air pockets to qualify for this kind of surgery.

Endobronchial Valve Treatment

EVT involves placing one-way valves into damaged lung portions that trap air and make it hard to inhale. The removable valve can make it easier to breathe. No incisions are needed — the doctor places an endobronchial valve using a bronchoscope (a tube inserted into your mouth or nose). EVT may be recommended for people who have severe emphysema.

Can COPD Be Treated With Surgery?

The answer depends on how you define “treated.” These surgeries don’t cure COPD or change your overall lung health. However, they can help reduce symptoms like shortness of breath and improve lung function to help you feel better when living with COPD.

Safety, Risk, and Surgery for COPD

Surgery for COPD is linked to several risks, so it’s natural to wonder, “Is it safe to have surgery with COPD?” People with COPD have a higher risk of serious complications and even death after any surgery, including surgeries unrelated to COPD. More research needs to be done to fully understand how much higher this risk is compared to that of people without COPD.

COPD surgeries also come with specific risks, including problems with wound healing and ongoing inflammation. Researchers need to do more studies on how likely these issues are and how severe they might become.

Other possible risks from surgery include:

• Pneumonia
• Pneumothorax (a collapsed lung)
• A blood clot
• Need for a ventilator (breathing machine) for more than two days

To help you heal well and avoid complications, it’s important to be as healthy and strong as possible before surgery.

Criteria To Reduce Risk Factors for COPD Surgery

To lower the risk of complications, most surgeons make sure you meet certain criteria to qualify for these treatments. In addition to having late-stage emphysema and not responding to other treatments, you may need to meet qualifications like:

• Being strong enough to both get through surgery and recover well
• Not being significantly underweight
• Quitting smoking, at least for a few months before the surgery
• Agreeing to participate in pulmonary rehabilitation after your surgery
• Having no other serious conditions that could affect healing

Your doctor will go over the specific criteria for your situation. They may run several tests to make sure surgery is a safe option and you have a good chance of doing well afterward. If you don’t qualify, your healthcare team will help you explore other treatments that fit your needs.

Costs of Surgery for COPD

Surgery can come with significant healthcare costs, including:

• The surgeon who performs the procedure
• The anesthesiologist (the person who manages anesthesia during the surgery)
• Your hospitalization
• Medications needed during and after surgery

Your total cost will depend on where you live, which hospital you go to, and which doctors are involved.

Your doctor may refer you to pulmonary rehabilitation after your surgery. Research shows that this type of program can help reduce the overall costs of managing COPD, so it’s worth investing in even if your doctor doesn’t require it.

How To Reduce Surgical Costs

You can take some practical steps to reduce your costs and make sure you get the most out of your medical coverage.

Start by talking with your doctors and your insurance provider, whether you pay privately or get coverage through Medicare or Medicaid. Make sure that everything included in the surgical plan will be covered. Also check that the hospital and any doctors you’ll work with are in-network, which usually means paying less. You may need a referral from your primary care doctor to reduce the cost of seeing a specialist.

You can also find out how much you’ll be billed for each part of the procedure and your care afterward. Your insurance provider should be able to tell you the amounts you’ll be responsible for.

If you can’t afford the out-of-pocket amounts, don’t hesitate to ask for help. Your doctor’s office or the hospital’s billing department may offer options so you can still get the medical care you need.

Lung Transplants and COPD

In some cases, a single or double lung transplant may be an option for treating COPD. These are usually considered only when all other treatments — including LVRS, bullectomy, and EVT — haven’t worked or aren’t possible. A lung transplant is a major surgery.

There are very specific criteria about who can qualify for a lung transplant. To be considered, you must:

• Be at high risk of dying from COPD or its complications within a few years
• Have stopped smoking for a long time
• Have no other serious medical conditions
• Be physically and emotionally ready for significant rehabilitation

A transplant is always high risk because your body could reject the new organ. You’ll have to take medications for the rest of your life to help your body accept and use the new lung.

In addition, there’s a shortage of healthy lungs for transplant. Many people with end-stage COPD don’t receive one, even if they qualify.

Your doctor will tell you if they believe a lung transplant might be right for you. You can also ask about this option. Your healthcare provider can help you understand whether you may be a candidate for a transplant — or any other type of surgery for COPD. Together, you can make a plan that fits your needs, supports your goals, and helps you breathe a little easier.

Talk With Others Who Understand

On MyCOPDTeam, the social network for people with COPD and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with COPD.

Have you had surgery for COPD? How did it improve your health-related quality of life? Share your experience in the comments below, or start a conversation by posting on your Activities page.