Traditional Versus Minimally Invasive Lung Cancer Surgery


by Elizabeth L Perkins - Date: 2010-03-02 - Word Count: 630 Share This!

There are a number of reasons surgery is performed on the lungs. The most common reason involves cancer. If a mass is identified within the lung tissue, a surgical team will be assigned to remove it. There are a few approaches that can be taken depending on where the mass is located as well as its size. Surgery may also be performed to correct a collapsed lung or to drain fluid that is accumulating nearby.

Today, minimally invasive techniques are used to reduce the likelihood of complications and provide a shorter recovery period for the patient. In this article, we'll provide an overview of the differences between traditional thoracotomy and minimally invasive lung cancer surgery. While the former is still performed in some circumstances, the latter is becoming increasingly common.

Types Of Surgical Procedures

First, it's worth reviewing the different operations performed on the lungs. As noted, most surgical procedures are done to cure lung cancer (LC). If the aforementioned mass is small and only found within a tiny portion of tissue, a wedge resection is performed to remove that portion.

In cases where the cancerous cells are detected within a larger portion of tissue, a lobectomy may be done. This is a procedure during which one entire lobe is removed. If it is necessary to remove two adjoining lobes, the procedure is called a bilobectomy.

When the diseased cells have spread throughout the lung, a surgeon will perform a pneumonectomy to remove the entire organ. Its absence will lower the patient's quality of life, but the patient can live with only one lung.

Minimally Invasive Approaches

Traditionally, lung cancer surgery was performed through an open chest operation (i.e. thoracotomy). A long incision is made into the patient's side between the ribs. The surgeon then uses a retractor to spread the patient's ribs in order to provide enough room to work. With the ribs spread apart, the surgeon accesses the site and removes the tumor.

Thoracoscopy can accomplish the same results without the need to make a long incision or spread the ribs. Instead, the surgeon will make several smaller incisions. A thin, tubular instrument called a thoracoscope is outfitted with a video camera and inserted through one of the small incisions. As the surgeon guides the thoracoscope to the affected tissue, the video camera transmits images of the chest cavity back to the surgical team.

Once the site has been identified, other instruments are inserted and guided to the diseased tissue. The portion containing the cancerous cells is cut away and removed.

Differences Between Traditional and Minimally Invasive Surgery

Because thoracotomy is so invasive, patients are exposed to several potential complications. These can include respiratory failure, internal bleeding, pneumonia, and air leaks. Moreover, the patient is forced to cope with intense postoperative pain during recovery.

With minimally invasive lung cancer surgery, the potential for complications is significantly reduced. There is also far less postoperative pain and the recovery period is shortened. It's not uncommon for patients to be released from the hospital after two or three days following surgery (compared to up to ten days following thoracotomy).

What To Expect After The Operation

After you undergo lung cancer surgery (assuming minimally invasive techniques are used), you will experience some level of tenderness near the incisions. The pain will eventually subside. Within a few days, you will be released to complete your recovery at home. Your doctor will prescribe pain medications to reduce any lingering discomfort. Once you no longer need these medications, you will be able to resume your normal activities. Most patients find they can return to their normal routine after four or five weeks.

Not everyone is a candidate for minimally invasive lung cancer surgery. Your doctor will want to perform a few tests to check whether this form of treatment is appropriate given the staging of the disease and your condition.


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