Sarasota Cardiac & Thoracic Surgery

Thoracic Procedures PDF - Click Here to Print

Many lung disorders require surgical investigation and/or treatment. In many cases, the first suspicion of lung disease may appear as an abnormality on a routine chest x-ray or lab test. Follow up imaging exams such as computerized tomography (CT) scans or magnetic resonance imaging (MRI) may clarify these findings; blood tests often provide additional data. Many lung problems require biopsy or removal (resection). Our surgeons have additional training and interest in thoracic surgery and we have outlined a few of the most common procedures they may provide for you.

Mediastinoscopy

Mediastinoscopy is an outpatient procedure that is performed most commonly to biopsy lymph nodes. Your surgeon makes a small incision just above the clavicle and a mediastinoscope is placed through that incision. The scope is advanced along side your trachea, and the lymph nodes that surround your trachea are biopsied.

Minimally Invasive Procedures

Whenever possible, minimally invasive surgery is performed. After minimally invasive operations patients recover more quickly and need less pain medication. A VATs (video assisted thoracoscopy) allows your surgeon to operate through 2 to 4 tiny openings between the ribs while viewing the procedure on a television monitor. This is performed with the assistance of a thin, fiberoptic scope with a camera attached. Instruments are then inserted into the chest through the small incisions made between the ribs. This allows your surgeon to take biopsies, confirm a diagnosis, and perform wedge resections (remove a section of the lung). You will need to have pulmonary function tests (PFTs) performed prior to the procedure to assess lung function. A chest tube will be placed at the time of the procedure to drain any fluids from surgery and help re-expand the lung. This will be removed when the drainage has stopped and there are no further air leaks, usually in a few days. The site will be tender for several weeks afterward and you will be discharged with pain medications. You will have no activity restrictions with the exception that you must not drive when using pain medications.

Lobectomy/Pneumonectomy

Lung surgery procedures will vary depending on the underlying disease. After reviewing your medical records, Dr. Beggs can offer you a variety of specialized surgical techniques. These can include pneumonectomy (removal of an entire lung), lobectomy (removal of a lobe of the lung), or less extensive resection may be a surgical option. Most patients with Stage I or II non-small cell lung cancer will receive this treatment for their disease, or a less extensive resection. A lobectomy may only be performed if a wedge or segmental resection is ineffective, but is generally preferred as treatment for primary lung cancer in any patient who can tolerate the procedure. In general, the surgery method chosen will depend on specific circumstances and consideration of benefit versus risk.

A lobectomy is performed through a thoracotomy, or incision in the chest wall, and will involve removal of an entire lobe of the lung. A patient will be placed under general anesthesia during the surgery. An incision is made to examine the lungs. Diseased tissue is removed and may be sent for biopsy. Following the surgery, drainage tubes will be placed in the chest to drain fluids, blood, and air from the chest cavity. Tubes will remain in place until drainage stops and the lung re-expands. The hospital stay averages from five to seven days. Patients will be carefully monitored for complications and infection. Deep breathing is recommended to help lessen the risk of pneumonia and infection. Breathing exercises will also help expand the lung. After discharge from the hospital, the patient may still receive some pain medications or antibiotics and should fully recover within one to three months of the operation.