Are you afraid of a lobectomy? Let's explain everything simply.

Have you or someone you know ever been told by a doctor that part of your lung needs to be surgically removed? It's normal to feel a lot of fear and anxiety when you hear those words. "They're removing a piece of my lung? Will I be able to breathe after that? Is this dangerous?" You probably have a lot of questions like these in your mind. Don't worry. Today, we're going to talk about this surgery, called a lobectomy, in a very simple way that you can understand.

Simply put, what is a lobectomy?

A lobectomy is the surgical removal of a section, or "lobe," of your lung. Did you know that our right lung has three lobes and our left lung has two? This surgery removes only the diseased lobe, leaving the healthy lobe intact.

This surgery is often done as a treatment for early-stage lung cancer. It is a very effective treatment, especially for non-small cell lung cancer . Sometimes, the doctor may decide to remove only part of a segment. This is called a segmentectomy .

What are the surgical methods?

In the past, this type of surgery was performed by making a large incision in the chest and removing the ribs. This is called a thoracotomy . But now, because of advances in technology, most surgeries are performed using minimally invasive methods. Simply put, this surgery is performed through a few small holes, without making a large incision.

• VATS (Video-Assisted Thoracoscopic Surgery): This involves making several small incisions in the side of the chest, inserting a small camera through one, and inserting surgical instruments through the other incisions. The doctor performs the surgery while viewing the inside of the lungs on a large screen. This method does not require breaking or moving the ribs.
• RATS (Robot-Assisted Thoracoscopic Surgery): This is very similar to VATS. However, here the surgeon controls the instruments through a system of robotic arms. This allows the surgery to be performed more delicately and accurately.

How do we prepare for this surgery?

Since this is a major surgery, several tests will be done beforehand to see how ready your body is for it. Don't panic after seeing these. This is all for your safety.

In addition to these tests, you will also see a cardiologist and an anesthesiologist. The anesthesiologist will explain the anesthesia you will be given during the surgery and how to manage pain after the surgery.

The doctor will also tell you exactly what time you should stop eating and drinking the night before the surgery.

What actually happens during surgery?

You don't need to worry about this at all. You will be given anesthesia before the surgery begins, so you will be completely asleep. You will not feel any pain.

1. A tube is placed down your throat and connected to a machine (ventilator) to help you breathe.

2. An IV tube will be inserted into a vein in your arm and the necessary medication will be given through it.

3. The surgeon then begins the surgery by making incisions in the chest using the previously discussed VATS, RATS, or Thoracotomy method.

4. The blood vessels and bronchial branches leading to the affected lung segment are carefully separated and the segment is completely removed. However, the blood vessels and bronchial branches leading to the other healthy segments are not damaged.

5. The removed part is placed in a special bag and taken out of the body.

6. If it is cancer, some of the healthy tissue around it will be removed. Some lymph nodes in the chest will also be removed and sent for testing to see if the cancer has spread.

7. After everything is finished, carefully check for any bleeding areas and thoroughly wash and clean the inside of the chest.

8. Finally, the incisions are closed with stitches or staples.

The entire surgery usually takes about two hours, but this can vary depending on the complexity of the surgery.

What happens after surgery? How to be cared for in the hospital

After the surgery, you will be woken up and taken to a recovery unit, where you will be given medication to control your pain.

• Once you're fully conscious, the breathing tube is removed. Most people don't even remember this.
• Then you will be transferred to a general ward or sometimes to the intensive care unit (ICU).
• You will have one or two tubes (chest drains) inserted in your chest. These drain the extra fluid and air that collects around your lungs. They will be removed in a few days.
• Cough and breathing exercises: The nurses will encourage you to cough frequently and take deep breaths. Although this may be a little painful, it is essential to keep your lungs well-expanded and prevent infections.
• To prevent blood clots in your legs while you are in bed, you can take blood-thinning medications and wear special compression devices on your legs.
• From the day after the surgery, I had to start walking little by little with the help of the nurses.

Let's also know about the benefits and risks.

As with any surgery, there are benefits as well as some risks.

Main advantage:

For early-stage lung cancer, this surgery is the best chance for a complete cure .

Possible risks (Complications):

These don't happen to everyone, but it's important to be aware of them.

• Atrial fibrillation - This is the most common complication.
• Excessive bleeding.
• Air leak from the lungs that lasts for several days.
• Blood clots in the legs.
• Chest infections.
• Neurological disorders (e.g., voice changes).
• Difficulty breathing during exercise.

How to recover quickly after going home?

If you have had surgery using a modern technique like VATS or RATS, you will be able to go home from the hospital in two to three days . The pain is less, so the recovery time is faster. You can usually return to light work, such as working in the office, after about two weeks. If you have a job that requires heavy lifting, you will need to rest for at least four weeks.

If you had open surgery (thoracotomy), you would have to stay in the hospital for three to four days , and it would take a little longer to recover.

After going home:

• You will be given strong painkillers for about a week.
• It would be great if someone was around to help in the beginning.
• Some people may need oxygen therapy at home for a while.
• Avoid driving until you have taken painkillers.
• You will have a follow-up appointment with your doctor within 1-3 weeks after surgery. He or she can discuss your test results, examine your wounds, and give you advice on how to proceed.

When do you need to talk to the doctor?

If you have signs of infection, such as fever, chills, and extreme fatigue, call your doctor immediately.

A few more questions you might have in mind:

Is this a major surgery?

Yes , a lobectomy is a major surgery because the lungs have very delicate and large blood vessels. So there is some risk.

What is the life expectancy after surgery?

This depends entirely on the stage of the cancer. This can be determined from the pathology report after surgery. In most cases, if it is removed in the early stages, a complete cure can be achieved.

Can the cancer come back?

There is a chance. That's why you are monitored with CT scans every six months for five years after surgery. If the cancer doesn't come back after five years, you are considered completely cured.