A two-phase surgical procedure is disclosed for creating a pneumostoma to treat chronic obstructive pulmonary disease The first phase is a procedure to induce creation of a localized pleurodesis and is preferably performed as an outpatient procedure. The second phase is a procedure to introduce a surgical instrument into the lung via the pleurodesis to create the pneumostoma. An interval of about one of more days between the first and second phases allows the formation of a stable pleurodesis to prevent pneumothorax during the procedure.