According to the American Cancer Society, nearly 220,000 new cases of lung cancer (LC) were diagnosed in 2009. Nearly 160,000 people died from the disease during the same year. It is the leading cause of cancer-related death among both genders. Surgical approaches to address the condition include wedge resections, lobectomies, and pneumonectomies. The purpose of this article is to explore the manner in which lobectomies are performed. This is an operation during which a single lobe of your lung is excised.
The operation has evolved considerably over the past several decades. It used to be an invasive procedure that was accompanied by a high level of postoperative pain and a long recovery period. Today, the approach taken by a growing number of surgeons yields a much more favorable outcome.
Below, we’ll revisit traditional lobectomies and explain how they are performed. While minimally invasive techniques are preferable, some circumstances make such an approach inappropriate. We’ll also describe the basics of a VATS lobectomy and explain some of the tests involved with determining whether you are a suitable candidate. Lastly, you’ll learn what to expect while recovering in the hospital and at home.
Traditional Lobectomy Explained
Traditional lobectomies are done through thoracotomy, an open chest approach. A long incision is made by the surgeon into the side of the chest between the ribs. The entire operation is completed through this single incision. The patient’s ribs are spread apart with a retractor to give the surgical team sufficient room to access the lungs. Then, the necessary instruments are inserted into the chest cavity in order to cut away and remove the diseased lobe.
Because thoracotomy is invasive, the patient will experience a significant amount of pain following the operation. Plus, several weeks are needed to recover to the point of resuming normal activity.
Basics Of A VATS Lobectomy
Lobectomies can also be performed using video-assisted thoracic surgery (VATS). This is a minimally invasive alternative to thoracotomy. Instead of making a long incision into the patient’s chest and spreading the ribs, the surgeon makes a few small incisions into both sides of the chest. Most are less than one inch.
A thin instrument called a thoracoscope is inserted through one of the incisions. It has a small light and camera affixed on its tip. As the surgeon guides the thoracoscope into the chest cavity, the camera sends images back to a video monitor. These images provide the surgeon with a clearer view of the lungs and surrounding structures than can be achieved through thoracotomy.
Additional instruments are inserted through the other small incisions to cut and extract the diseased lobe.
Determining Whether You Are A Candidate
Patients who have lung cancer that has progressed into stage II may not be suitable candidates for a VATS lobectomy. The procedure is usually reserved for those with tumors smaller than 3 centimeters. Moreover, if the cancerous cells have metastasized beyond the lungs, video-assisted thoracic surgery is typically excluded as an option. In such cases, as well as those in which the tumors are large, traditional thoracotomy is often recommended.
Recovering In The Hospital And At Home
Following the VATS lung cancer surgery, you can expect to stay in the hospital for up to four days (though some patients are released in as few as two days). During that time, the nurses and surgical team will work closely with you to help you recover. Once your doctor is convinced that your body has tolerated the procedure and is recovering well, you will be released from the hospital.
Before returning home, your doctor will provide instructions regarding how to keep the incision sites clean, types of activities to avoid, and a recommended diet. Most patients are able to return to their jobs (unless their work requires strenuous activity) within a few weeks. By the sixth week, you may be able to resume your normal routine, including strenuous activities.
VATS lobectomies are a popular approach to resolving early stage lung cancer. Speak with your doctor to determine whether this minimally invasive technique is available and appropriate for your circumstances.