Your Lobectomy Procedure

What Will Happen During My Lobectomy Surgery?

diagram of the lungs
What happens during a lobectomy surgery?. A.D.A.M. Medical Encyclopedia

Article 3 - Your Lobectomy Procedure

Note: This article discusses what happens in the operating room during a lobectomy. If instead, you would like to learn about the types of lobectomy, how to prepare, recovery, or possible complications, check out the following articles:

    A lobectomy is a lung cancer surgery in which one lobe of a lung is removed. It removes more lung tissue than a wedge resection, but less than a pneumonectomy.

    During Your Lobectomy Surgery

    During your lobectomy procedure, your surgeon will remove the lobe of your lung that is affected by lung cancer. Depending upon the type of lobectomy procedure your surgeon recommends, your cancer may be removed through an open incision or through the use of instruments inserted through smaller incisions. Here's what will happen during your lobectomy procedure.

    In the operating room, you will be given a general anesthetic to put you to sleep, and an endotracheal tube will be placed through your mouth to allow a ventilator to breathe for you during surgery.

    Open vs VATS Lobectomy

    In an open lobectomy, a long incision will be made along your side following the curve of your ribs.The surgeon will spread your ribs and may remove a portion of a rib to gain access to your lung.

    The blood vessels (arteries and veins) and airways leading to the affected lobe are tied off, and the lobe is then removed. Prior to closing the incisions, your surgeon will insert a chest tube that will be left in place for a period of time. The chest tube allows excess blood and fluids to drain following surgery, and will be removed when the drainage has stopped.

    With a VATS lobectomy, surgeons make several small incisions on your chest through which they can insert instruments and a small video camera (a thoracoscope). The camera projects an image onto a video screen that allows the surgeons to see the area they are working on. The blood vessels and airways to the involved lobe are tied off with the use of these instruments, and the lobe is removed through one of the incisions. Following removal of the lobe, surgeons may also biopsy or remove lymph nodes in the area near the tumor.

    Sometimes surgeons encounter problems during a VATS lobectomy, such as bleeding or a tumor that cannot be adequately removed. In this case, the procedure may need to be converted to an open lobectomy.

    Choosing a Surgeon

    It's important to think carefully about your lobectomy before the procedure. It's been found that hospitals that perform greater volumes of lung cancer surgery have better outcomes. For you, that might mean fewer complications or more effective removal of cancerous lung tissue.

    Here are some tips on how to choose a cancer center.

     Strongly consider getting a second opinion. Not all surgeons are comfortable performing surgeries such as VATS lobectomy. While this approach cannot always be taken, it's worth considering (and finding a surgeon who performs this technique) as it is a less invasive procedure with an easier recovery most of the time. Your surgeon will not be upset if you request a second opinion, and in fact, most surgeons expect that patients will do so. You may wish to consider one of the larger National Cancer Institute-designated cancer centers for a second opinion, as some of these centers are more likely to have surgeons on staff who specialize in lung cancer surgery.

    Next Article - Recovery After Your Lobectomy


    American Cancer Society. Detailed Guide: Lung Cancer – Non-Small Cell. Surgery. Updated 02/08/16.

    Erhunmwunsee, L. and M. Onaitis. Smoking cessation and the success of lung cancer surgery. Current Oncology Reports. 2009. 11(4):269-74.

    Whitson, B. et al. Surgery for early-stage non-small cell lung cancer: a systematic review of the video-assisted thoracoscopy surgery versus thoracotomy applications to lobectomy. Annals of Thoracic Surgery. 2008. 86(6):2008-16.

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