Minimally Invasive Lung Cancer Surgery

Lung cancer is a complex disease with several treatment options.

You will likely receive many forms of treatment, including chemotherapy, radiation, and surgery.

At the UPMC Esophageal and Lung Surgery Institute, we offer minimally invasive surgery options to remove all or part of the cancerous cells in the lung.

Types of Minimally Invasive Lung Cancer Surgery

Biopsy

You may need a biopsy to confirm the stage and type of lung cancer. Surgeons at UPMC use minimally invasive techniques to perform a biopsy whenever possible.

During a biopsy, the surgeon removes a small section of lung tissue in one of two ways:

• Through a bronchoscope, by inserting a tube through the mouth or nose).
• With a needle.

During a CT-guided needle biopsy, the surgeon uses a CT scan to guide a large needle to the abnormal lung tissue.

Your surgeon will send your tissue sample to a pathologist who will study it under a microscope.

Wedge resection

At the earliest stages of lung cancer, you may need a wedge resection.

During a wedge resection, your surgeon will:

• Insert a small camera in the chest to view the lung tumor.
• Remove just the tumor and a small number of normal cells within the lung to aid in diagnosis.
• Send the sample to a pathologist to see if the lung tumor is cancerous.

If the pathologist confirms you have lung cancer, he or she will learn more about the type of tumor. This informs your surgeon of further treatment decisions.

Lobectomy

When you've received a formal diagnosis of lung cancer, your doctor may suggest a lobectomy.

This is a delicate procedure. It involves removing the entire portion — or lobe — of the lung that contains cancer. In some cases, your surgeon may need to remove the entire lung.

Whenever possible, UPMC surgeons will choose the least invasive surgery that saves as much of the lung as possible.

Benefits of Minimally Invasive Lung Surgery

Most traditional lung surgeries require large incisions to allow more access inside the chest.

With advances in minimally invasive techniques, surgeons can perform the same procedure with much smaller incisions.

At the UPMC Esophageal and Lung Surgery Institute, we also have the ability and expertise to perform lung surgery robotically.

Minimally invasive lung cancer surgery helps:

• Reduce pain.
• Leave you with less scarring.
• Help you recover faster.

What to Expect from Minimally Invasive Lung Cancer Surgery

Before lung surgery

Your care team will give you detailed instructions to follow the week or days before your lung cancer surgery.

These will tell you what drugs to stop taking and provide any dietary restrictions.

During lung surgery

You will receive general anesthesia and sleep throughout the operation.

With minimally invasive lung cancer surgery, your surgeon will make a few small incisions to insert a camera and surgical tools in the chest. Your surgeon may use video-assisted thoracoscopic surgery (VATS) or the robot.

• VATS allows the surgeon to view the images from the camera and use that image to guide the tools and remove the affected portion of the lung.
• When done robotically, the surgeon sits at a console with a 3D screen and manipulates the surgical instruments. He or she is always in control of the tools and the robot-assisted surgery allows for delicacy to limit trauma to the rib cage.

The length of surgery varies depending on how large of a section of lung your surgeon needs to remove.

A wedge resection can be quick, while a larger lobectomy can take several hours.

After lung surgery

With a wedge resection, you may be able to go home the next day. You can often return to normal activities within a week or two.

With a lobectomy, you can expect to spend about three days in the hospital. While you're in the hospital, you will have a chest drainage tube.

Blood clots are the primary concern after lung surgery.

To reduce the risk of blood clots, you will need to:

• Get up and take small walks every day.
• Wear compression socks while in the bed.
• Take a blood thinner.

Before going home, you will learn to do breathing exercises and use an incentive spirometer. This device helps you practice taking deep breaths and prevent infections.

Minimally invasive lung surgery recovery

Recovering from a lobectomy varies by the extent of the surgery. In most cases, it takes at least four weeks before you feel like yourself again.

Some tips to help you recover after lung cancer surgery:

• Walk every day, as much as you can. Take rests when you need to, but continuing to move will help prevent blood clots.
• Keep using the incentive spirometer at home.
• Slowly build up physical activity but avoid any heavy lifting for a few months.

To help you prevent lung infections and encourage healing, try your best to avoid being around:

• People with respiratory infections or illness.
• Tobacco smoke.
• Areas with high levels of air pollution.

Your care team will follow your progress throughout your recovery. Our goal is to help you return to your normal life.

Contact us at the UPMC Esophageal and Lung Surgery Institute any time you have questions or suspect that you may have complications from surgery.