(Thoracotomy, Thoracoscopic Lobectomy, Removal of a Lobe of the Lungs, Lung Surgery)
A lobectomy is a surgical procedure performed to remove one of the lobes of the lungs. The procedure may be performed when an abnormality has been detected in a specific part of the lung. When only the affected lobe of the lung is removed, the remaining healthy tissue is spared to maintain adequate lung function.
A lobectomy is most often performed during a surgical procedure called a thoracotomy (surgical incision of the chest). Other lung surgery procedures that may be performed by thoracotomy include:
There are different kinds of thoracotomies depending on the location of surgical entry and how much lung is removed. Generally, during a lobectomy the incision is made at the level of the affected lobe. The incision is typically made on the front of the chest under the nipple line and extends around the back under the shoulder blade. The surgeon enters the chest cavity through the exposed ribs to remove the lobe.
In certain circumstances, a minimally invasive procedure called video-assisted thoracic surgery (VATS) is used to perform a lobectomy. Specialized surgical instruments are inserted into the chest cavity through three or four small incisions. One of the instruments, a thoracoscope, has a tiny camera and transmits the image to a TV-like monitor. The surgeon is able to view the internal organs on the monitor. Through the remaining incisions, other specialized instruments are inserted and used to perform the procedure. The type of procedure performed will be determined by the surgeon, based on the patient's medical condition and other factors.
Other related procedures that may be used to diagnose problems of the lungs and respiratory tract include lung biopsy, pleural biopsy, bronchoscopy, thoracentesis, and mediastinoscopy. Please see these procedures for additional information.
The respiratory system is made up of the organs involved in the exchange of gases--primarily oxygen and carbon dioxide--and consists of the:
The upper respiratory tract includes the:
The lower respiratory tract includes the lungs, bronchi, and alveoli.
The lungs take in oxygen, which cells need to live and carry out their normal functions. The lungs also get rid of carbon dioxide, a waste product of the body's cells.
The lungs are a pair of cone-shaped organs made up of spongy, pinkish-gray tissue. They take up most of the space in the chest, or the thorax (the part of the body between the base of the neck and diaphragm).
The lungs are enveloped in a membrane called the pleura.
The lungs are separated from each other by the mediastinum, an area that contains the following:
The right lung has three sections called lobes. The left lung has two lobes. When you breathe, the air enters the body through the nose or the mouth. It then travels down the throat through the larynx (voice box) and trachea (windpipe) and goes into the lungs through tubes called mainstem bronchi.
One mainstem bronchus leads to the right lung and one to the left lung. In the lungs, the mainstem bronchi divide into smaller bronchi and then into even smaller tubes called bronchioles. Bronchioles end in tiny air sacs called alveoli.
A lobectomy may be performed when a lung abnormality or condition has been identified that requires surgical removal. A lobe may be removed to avoid spread of the disease-causing pathogen to the other lobes, as with tuberculosis or certain cancerous lung tumors.
Conditions of the chest and lungs for which a lobectomy may be performed include, but are not limited to, the following:
There may be other reasons for your doctor to recommend a lobectomy.
As with any surgical procedure, complications may occur. Some possible complications include, but are not limited to, the following:
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.
A lobectomy requires a hospital stay of several days. Procedures may vary depending on your condition and your doctor’s practices.
Generally, a lobectomy follows this process:
After the procedure, you will be taken to the recovery room for observation. Your recovery process will vary depending on the type of procedure performed and the type of anesthesia that is given. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room.
You may receive pain medication as needed, either by a nurse, through an epidural catheter, or by administering it yourself through a device connected to your intravenous line.
You may have one or more chest tubes inserted near the surgical incision to drain air and/or fluid from the chest. The chest tubes may be painful when you move, cough, or breathe deeply. The chest tubes will be removed before you are discharged from the hospital.
You may need to receive oxygen for a period of time after surgery. Generally, the oxygen will be discontinued before you go home. However, some patients may need to go home with oxygen, depending on their medical condition.
You will be taught deep-breathing exercises and coughing techniques to help facilitate lung re-expansion and prevent postoperative pneumonia.
You will be encouraged to move around as tolerated while you are in bed and to get out of bed and walk around as your strength improves.
Depending on your situation, you may be given liquids to drink a few hours after surgery. Your diet may be gradually advanced to more solid foods as tolerated.
Before you are discharged from the hospital, arrangements will be made for a follow-up visit with your doctor. The length of time may vary depending on the reason for your lobectomy.
Once you are home, it is important to keep the incision clean and dry. Your doctor will give you specific bathing instructions. The stitches or surgical staples will be removed during a follow-up office visit.
The incision, and chest and shoulder muscles, may ache, especially with deep breathing, coughing, and exertion. Take a pain reliever for soreness as recommended by your doctor. Aspirin or certain other pain medications may increase the chance of bleeding. Be sure to take only recommended medications.
You should continue the breathing exercises used in the hospital.
You will be advised to avoid exposure to upper respiratory infections (colds and flu) and irritants, such as tobacco smoke, fumes, and environmental pollution.
You should gradually increase your physical activity as tolerated. It may take several weeks to return to your previous levels of stamina.
You may be instructed to avoid lifting heavy items for several months in order to prevent strain on your chest muscles and surgical incision.
Notify your doctor to report any of the following:
Following a lobectomy, your doctor may give you additional or alternate instructions, depending on your particular situation.
The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your doctor. Please consult your health care provider with any questions or concerns you may have regarding your condition.
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