Lung Surgery and Thoracic Surgery

Lung Surgery BoulderThe lungs are a pair of breathing organs located within the chest which remove carbon dioxide from and bring oxygen to the blood. There is a right and left lung. Lung surgery is used to repair or remove lung tissue. Thoracic surgery refers to procedures on the chest wall or soft tissues of the chest (mediastinum).

Conditions Treated

Lung Mass or Nodule

Lung Cancer

Pneumothorax (collapsed lung)

Hyperhidrosis (excessive sweating)

Mediastinal mass

Chest Wall tumors

Empyema (lung infection)

Procedures Performed

  • Lung Resection– Partial or complete removal of a portion of the lung (Lobectomy, Wedge resection, Pneumonectomy).
  • Decortication – Surgery to remove an infection or blood in the chest cavity.
  • Pleurodesis – Surgery to remove small balloon-like tissues (blebs) that cause lung collapse (pneumothorax). The chest wall is then abraded to prevent recurrence.
  • VATS (Video Assisted Thorascopic Surgery).
  • Sympathectomy – division of the Sympathetic Nerve in the chest to reduce excessive sweating.

Two common ways to do surgery on your lungs are thoracotomy and video-assisted thoracoscopic surgery (VATS).

Thoracotomy

Lung surgery using a thoracotomy is called open surgery. In this surgery:

  • You will lie on your side on an operating table. Your arm will be placed above your head.
  • Your surgeon will make a surgical cut between two ribs. The cut will go from the front of your chest wall to your back, passing just underneath the armpit. The muscles are often spared. These ribs will be separated.
  • Your lung on this side will be deflated so that air will not move in and out of it during surgery. This makes it easier for the surgeon to operate on the lung.
  • How much lung tissue needs to be removed may not be determined until your chest is open and the lung can be seen.
  • Lymph nodes in this area will often be removed during cancer operations or mediastinal biopsies.
  • After surgery, one or more tubes will be placed into your chest area to drain out fluids that build up. These tubes are called chest tubes.
  • After the surgery on your lungs, your surgeon will close the ribs, muscles, and skin with sutures.
  • Open lung surgery may take from 2 to 6 hours.

VATS Procedure – Video-assisted Thoracic Surgery

  • Several small surgical cuts will be created over your chest wall. A thorascope (a tube with a tiny camera on the end) and other small tools will be passed through these cuts.
  • Part or all of your lung may be removed, fluid or blood that has built up may be drained, or other procedures can be performed.
  • One or more tubes will be placed into your chest to drain out fluids that build up.

Mediastinoscopy

  • A small incision is created at the base of the neck to allow placement of a lighted scope to sample lymph nodes or masses within the upper chest cavity.

Getting Back to Normal

Most people stay in the hospital for 5 to 7 days for open thoracotomy and 1 to 3 days after Video-Assisted Thoracoscopic Surgery (VATS). You may spend time in the intensive care unit (ICU) after either surgery.

During your hospital stay, you will:

  • Be asked to sit on the side of the bed and walk as soon as possible after surgery to prevent blood clots in your legs (DVT).
  • Have tube(s) coming out of the side of your chest to drain fluids.
  • Wear special stockings on your feet and legs to prevent blood clots.
  • Receive pain medicine through an IV (a tube that goes into your veins) or by mouth with pills. You may receive your pain medicine through a special machine that gives you a dose of pain medicine when you push a button. This allows you to control how much pain medicine you get.
  • Be asked to do a lot of deep breathing to help prevent pneumonia and infection. Deep breathing exercises also help inflate the lung that was operated on. Your chest tube(s) will remain in place until your lung has fully inflated.