Lung Surgery

---

 Surgical Procedures

A biopsy obtains a tissue sample that can be sent to the lab for diagnosis.  A tumor or mass in the lungs or chest can be due to many things.  Some are primary lung cancers, others are the result of malignancies from elsewhere in the body and others are noncancerous or benign. Determining the type of tumor is important in developing a treatment plan. Biopsies can be obtained through a bronchoscopy, mediastinoscopy or thoracoscopy. 
 
Bronchoscopy  

A bronchoscopy is a procedure that allows for visualization of the trachea, bronchial tree and lungs plus the ability to obtain a tissue sample for biopsy. The bronchoscope is a thin scope that is passed through the nose or mouth down thru the trachea and into the bronchi and lungs. The doctor can examine your trachea and bronchi as well as take a sample of tissue anywhere along the way.

This is a surgical procedure that allows your surgeon to see the middle of your upper chest between and in front of your lungs. A small incision is made above the breastbone or just to the side of the breast bone, then a thin scope is inserted into the chest so the surgeon can examine your lymph nodes, outside of the trachea and esophagus and lung surfaces.  Biopsies (a tissue sample) can be collected through the scope of any suspicious areas and sent to pathology to be examined for problems such as cancer, inflammation or infection.

A thin scope inserted through an incision into the chest for suspected tumors in the chest or pleura unable to be reached by the above methods.

An extension of the thoracoscopy procedure which allows for the surgeon to visualize the thoracic cavity more completely and dissect some areas of the chest for diagnostic and therapeutic purposes. Some lung wedge resections can be performed with this method.

A thoracotomy is a surgical procedure done to open the chest in order to access the lungs, trachea, esophagus, heart, and certain blood vessels.  The incision is in the side of the chest either left or right, that can be of varying lengths which allows the surgeon to have a wider field in which to operate.  This type of procedure can be utilized for a variety of reasons including:

•    Establishing a diagnosis of chest disease
•    Removing a portion of the lung or the entire lung due to disease
•    Trachea resection
•    Esophagus surgery
•    Removing blood or infection from the chest cavity or pleural space
•    Surgery because of trauma to the chest
•    Surgery on certain blood vesels including the aorta

The surgical incision made through the breastbone (sternum). When the operation is completed the breastbone (sternum) is wired together and allowed to heal, (like you would expect a broken bone to heal). The wires remain in place unless they cause a problem for an individual patient and then they can be removed.~

Lung resections are for benign and malignant cancers: Depending on the tumor type, size and location, several surgical interventions may be considered. Wedge resection, where a segment or small portion of a lung lobe is removed. Lobectomy, where a lobe of the lung is removed. There are three lobes on the right and two on the left. Pneumonectomy, where the entire lung on one side is removed. Sleeve Resection, where a section of the intervening tumor is removed from the involved lung and bronchus and then a re-anastomosis of the bronchus is done. 

Radiofrequency Ablation  

Radiofrequency ablation of lung tumors is a newer procedure that has been developed to eradicate and destroy focal tumors of the lung and chest. It is a minimally invasive non-surgical procedure performed in the interventional oncology suite very similar to a biopsy. It involves using CT guidance to accurately place a "needle/probe" directly into the tumor. Once the needle is in position it is attached to a generator that delivers radiofrequency pulses that heat and completely ablate/destroy the tumor. The procedure is done as an outpatient or a single night stay in the hospital. Patients recover within hours. This procedure is not to replace open surgical resection and is typically performed for patients that are not surgical candidates. It may be appropriate in up to 30% of patients with lung cancer. It is also a useful addition to traditional radiation therapy.

This procedure removes a restrictive, fibrous membrane or layer of tissue from the pleural surface of the lung. It may also be removed from the diaphragm or chest wall. This procedure is used in the treatment of chronic pleural infections or empyemas. The purpose of the procedure is to free the encased or “trapped lung” allowing the expansion of the lung to become easier. 

 Lung Transplant  

Single and bilateral lung transplants are performed for end-stage pulmonary disease. For more information on transplantation go to Lung Transplantation.

A procedure for individuals with emphysema involving removal of sections of the diseased lung. This allows the remaining lung tissue and chest cavity to function more efficiently and eases the work of breathing.

A procedure to produce adhesions between the visceral and parietal pleura. This is done to treat pleural effusions that re-occur frequently. The adhesions result in the two pleural layers sticking together so the space is no longer there to accumulate fluid.

This procedure resects the area of lung tissue that has formed blister like spots on the lung causing difficulty in lung expansion. Patients with blebs may experience extreme shortness of breath due to the lung collapsing (pneumothorax).