Should we know everything about lobectomy?

Have you or someone you know been told by a doctor that they need to have surgery for a lung problem? It's normal to feel a little scared, curious, and have a lot of questions at a time like this. You may be wondering things like, "Is this a big operation? Will it hurt? What happens after that?" So today we're going to talk in a very simple and friendly way about a major lung surgery called a 'lobectomy.' Let's see what it is, why it's done, and what you need to know about it.

What is a lobectomy in simple terms?

Simply put, a lobectomy is the surgical removal of a part (lobe) of your lung. Our lungs are made up of several lobes, or lobes. The right lung has three lobes and the left lung has two lobes. This surgery removes only the diseased part of the lung, while preserving the remaining healthy parts of the lung.

This surgery is often done as a treatment for early-stage lung cancer (non-small cell lung cancer). Also, sometimes the doctor may decide to remove only a small part of the lobe instead of the entire lobe. This is called a segmentectomy.

In addition to lung cancer, this surgery may be performed for several other reasons.

How is this surgery done?

Unlike in the past, these days, this surgery is often performed without opening the chest, using very small incisions. We call this 'minimally invasive methods'. There are two main methods.

1. VATS (Video-Assisted Thoracoscopic Surgery): This involves making several very small incisions in your ribs, inserting a small video camera through one, and surgical instruments through other incisions. The surgeon performs the surgery while viewing a clear image of your lungs on a large screen. This method does not require breaking or moving any ribs.

2. RATS (Robot-Assisted Thoracoscopic Surgery): This is similar to VATS, but here the surgeon controls the equipment with the help of several robotic arms.

However, in some complex cases, doctors may have to perform surgery by making a larger incision in the chest and moving the ribs slightly apart. This procedure is called a thoracotomy .

How do you prepare before surgery?

Before a major surgery like this, several tests are performed to accurately assess your health status.

• A complete physical examination.
• Imaging tests such as a chest X-ray, CT scan, or PET scan.
• Pulmonary function tests to check for breathing difficulties.
• Taking a small piece of lung tissue or lymph nodes for examination (biopsy).
• Blood tests.
• Tests like `(ECG)` and `(echocardiogram)` to check the functioning of the heart.

If you have lung cancer, knowing whether it has spread to other parts of the body (staging) is important for planning treatment. Also, if you have a history of heart disease, you may need to see a cardiologist before surgery. The anesthesiologist will explain how to manage pain during and after surgery.

The doctor will also inform you in advance what time you should stop eating and drinking the night before the surgery.

What happens after the surgery? How long does it take to recover?

After the surgery, you will be woken up and sent to the recovery unit. Here, you will be given medication to control your pain. Once you are fully conscious, the breathing tube will be removed. Many people don't remember this.

• You will then be transferred to a general ward or sometimes to the intensive care unit (ICU).
• One or two chest drains will be placed in your chest to remove excess fluid and air from the area where the surgery was performed. Once the amount of fluid coming out of them has decreased, the doctor will remove the tubes.
• The medical staff will encourage you to cough frequently and do deep breathing exercises . This is very important for your lungs to recover.
• Blood thinners and compression devices are used to prevent blood clots in the legs while you are in bed.
• Helping you walk the day after surgery is also an important part of the healing process.

If you have surgery using a technique like VATS or RATS, you will only need to stay in the hospital for two or three days . Recovery is also faster. If you have open chest surgery, you will need to stay in the hospital for three to four days . When you go home, you will be given strong painkillers to use for about a week. Although you can do your own work at home, it is good to have someone nearby for help.

What are the benefits and risks of this surgery?

The biggest advantage of this surgery is that it offers the best chance of a complete cure for someone with early-stage lung cancer . That's a great hope. And like all surgeries, there are some risks involved.

When do you want to see the doctor again?

After you go home, if you develop signs of infection, such as fever, chills, and extreme fatigue , you should call your doctor immediately.

Your doctor will schedule a follow-up visit 1 to 3 weeks after your surgery. He or she will take an X-ray of your chest, examine your wounds, and discuss your progress. Depending on the stage of your cancer, you may be referred to an oncologist . Your condition will be monitored with CT scans at regular intervals over the next five years.

Lobectomy, lung cancer, surgery, VATS, RATS, thoracotomy