Operations are performed to remove a portion of the lung or the entire lung. It is the gold standard for treatment of lung cancer with the hope of a cure. In 1992, our thoracic surgeons pioneered the use of minimally invasive video-assisted thoracic surgery (VATS), and continue to develop innovative approaches to achieving the best outcomes for lung cancer patients.
Types of Surgery
- Wedge resection: The lung is cut like cutting a piece of pie to remove a piece of lung.
- Segmentectomy: There are 10 segments in each lung. Removal of a segment is called a segmentectomy. In selected cases, segmentectomy can provided as good a chance for cure as removal of a lobe.
- Lobectomy: There are 3 lobes in the right lung and 2 in the left lung. Removal of an entire lobe of the lung is the most common operation to remove a lung cancer in the hope of a cure.
- Pneumonectomy: Removal of an entire lung.
- Sleeve resection: Removal of a piece of bronchus, and then reattach the remaining part of the bronchus.
- Open-chest surgery (Thoracotomy): For many years, chest surgery was performed through incisions 6 to 10 inches long. The ribs are spread open to allow a thoracic surgeon to get hands in to the chest to perform an operation. Currently, open procedures are less common, as minimally invasive surgeries are easier on the patient and equally effective. Sometimes, major open surgery is required, such as when the tumor is very large.
- VATS (Video-Assisted Thoracoscopic Surgery): is a minimally invasive procedure that involves the insertion of a small camera and surgical instruments through small incisions in the chest. This is less invasive than big chest incisions that require spreading the ribs. VATS lobectomy usually involves three small incisions without any spreading of the ribs, although in selected cases we use only 1 incision (Uniport). A camera is used to assist the dissection of sensitive blood vessels and lung structures. Less pain and quicker recovery are the goals. If chemotherapy is necessary after surgery, patients are healthier and can more reliably begin their adjuvant additional therapy.
Currently, smaller, less complicated procedures, such as wedge resections, are usually performed with VATS. At the John Wayne Cancer Institute, our thoracic surgeons perform over 90% of their lung cancer operations with minimally invasive surgery. Our papers in medical journals have shown this reduces complications and length of stay in the hospital without compromising the chance of a cure. We pioneered this technique.
- RATS (Robot-Assisted Thoracic Surgery) is a minimally invasive surgery, that allows for greater surgical precision, enhanced visualization and increased range of motion. The robot acts as a miniaturized extension of the surgeon’s arms and hands, which allow the surgeon to perform complex surgical procedures through small incisions, instead of using previously required large incisions for traditional surgery.
- Segmental/wedge resection and lobectomy are both done with minimally invasive surgical procedures that use small incisions and specialized instruments with video-scopes to guide the surgical process. Many patients come to us after learning they are not candidates for traditional surgery, and we are able to provide innovative surgical options that are safe and effective.