COPD represented 4% of all deaths in Australia in 2022. Lung volume reduction surgery (LVRS) uptake was minimal until landmark NETT, where LVRS offered survival benefit for those with predominantly upper lobe emphysema and low exercise capacity. Endobronchial lung volume reduction (ELVR) describes one-way outflow endobronchial valves (EBV) deployed into diseased bronchi to increase functional capacity. Its purported advantages are less in-hospital morbidity and quicker recovery than LVRS. Unfortunately, without complete interlobar fissures, Collateral Ventilation (COVE) results its failure. COVE study proposed VATS fissure completion on incomplete interlobar fissures to removal collateral ventilation, prior to EBV insertion. Aim: To show this novel surgical method has similar improvements on lung function, exercise tolerance and QoL as LVRS or EBV-alone cohorts, with no worse morbidity or mortality than LVRS. Methods: A prospective, single arm study was conducted. 20 patients with severe COPD and COVE were to be recruited. Specially formatted CT Chest scans determined the optimal lobe and degree of fissure completion required. Lung function, lung volumes, exercise tolerance, dyspnoea and QoL questionnaires were assessed at 6 months. Results: Recruitment was interrupted due to COVID Pandemic. 13 patients were recruited and nine were eligible. The mean difference in QoL using SGRQ score (-31.7 points) was significantly improved at 6 months (p< 0.001). Mean difference in distance covered during 6MWT (45.25m) was significantly greater at 6 months (p=0.003). Mean residual volume reduction was 0.28 litres. Although a large clinically important difference, it was not statistically significant. Conclusion: Despite a smaller cohort than planned, our study concluded that patients with severe emphysema and collateral ventilation had quality of life benefits and improved exercise tolerance after VATS fissure completion followed by insertion of EBV.