Lung cancer is one of the leading causes of cancer deaths. You have a better chance of surviving a lung cancer when your disease is detected in its early stage (stage I) and you undergo a procedure known as lobectomy. Lobectomy is a surgical procedure to remove one of the lobes of the lungs where your affected tissues or tumor are located. Previously, lobectomy used to be performed with an open procedure known as thoracotomy, where your surgeon would make an incision in your chest and spread your ribs apart in order to gain access into your chest cavity and remove your affected tissues. This necessitated a bigger incision and resulted in a longer hospitalization and recovery period.
Video-assisted thoracic surgery (VATS) lobectomy is a minimally invasive procedure, where your surgeon would make three 1-inch incisions and one 4-inch incision in order to gain access into your chest cavity without spreading your ribs.
During this procedure, your surgeon will insert a long slender tube fitted with a video camera (thoracoscope) and other surgical instruments through the previously placed small incisions. The video camera relays images of your chest cavity/operative site onto a monitor, which guides your surgeon to maneuver the surgical instruments and resect the affected tissues/tumor of your lungs through the small incisions.
A VATS lobectomy procedure is indicated in:
Advantages of VATS Lobectomy
Some of the possible risks associated with a VATS lobectomy procedure include bleeding, infection, anesthesia complications, air leak in your lungs that does not heal, damage to the adjoining tissues, accumulation of pus in your chest cavity (empyema), and ongoing pain in your chest wall.
A pneumonectomy refers to the surgical removal of the entire lung to treat lung cancer. There are two types of pneumonectomy:
Pneumonectomy is usually performed to treat cancers that are
Pneumonectomy may also be performed to treat traumatic chest injuries and chronic obstructive pulmonary disease (COPD) that causes airway obstruction.
Pneumonectomy is performed under general anesthesia. An endotracheal tube is inserted into your mouth through the windpipe to facilitate breathing during the surgery. Your surgeon makes an incision on your chest on the side of the diseased lung, along the ribs. The ribs are separated and a portion of the rib may be removed to provide a better view and access to the diseased lung. The lung is then collapsed. The major blood vessels and the main air tube (bronchus) of the lung are clamped and tied off. The cut end of the bronchus is closed with stitches or staples. The diseased lung is now removed from the chest cavity. The bronchus and blood vessels are checked for leakage of air and bleeding. Your surgeon then closes the incision in the chest wall with surgical sutures.
Post-operative care and recovery
Following surgery, you will have an intravenous (IV) line to provide fluids and pain relieving medicines. The ventilator is removed and you will be asked to cough in order to clear the airways. You will also be taught breathing exercises to prevent infection and inflammation. You will be required to stay in the hospital for 7-10 days. After discharge, you are advised against driving for a week, lifting heavy weights and other strenuous activities. Breathing exercises and mild physical activity like walking are encouraged for better blood circulation and muscle strength. You can get back to work in about eight weeks. Call your doctor immediately in case you develop the following symptoms after pneumonectomy:
Risks and complications
As with all surgical procedures, pneumonectomy may be associated with complications, including: