Addressing Lung Cancer With Minimally-invasive Vvats Lobectomy

If lung cancer (LC) is diagnosed early enough, it can often be resolved with a wedge resection. The diseased portion of lung tissue is cut away from the organ, along with a surrounding perimeter of healthy tissue. In most cases, however, the tumor goes undetected long enough for the cancerous cells to spread. As a result, resolving LC requires a slightly more aggressive approach. The surgeon must remove one of the lobes by performing an operation known as a lobectomy.

The operation has traditionally been done through invasive thoracotomy - that is, cutting through the chest to access the lungs. In recent years, surgeons have begun using a minimally-invasive approach known as video-assisted thoracic surgery (VATS). Below, we'll describe the differences between VATS and conventional thoracotomy. We'll then take a look at how patients are chosen for the former. Lastly, we'll explain what you can expect during recovery following a VATS lobectomy.

VATS Lobectomy Versus Invasive Thoracotomy

During thoracotomy, a surgeon makes a long incision into the middle of your chest. He or she must also cut through your sternum and spread your ribs in order to gain access to your lungs. In some cases, a portion of one or more ribs is removed.

Because this approach is highly invasive, the risk of complications is high. The operation may result in infection, respiratory failure, or pleural effusion. Moreover, there is typically significant pain during the postoperative recovery period.

In contrast, the surgery is done with two to four small incisions into the sides of the chest, with each measuring less than an inch. A thoracoscope (i.e. instrument with a video camera) is inserted through one of the incisions. It sends images of the area back to a monitor that your surgeon uses to guide other surgical instruments. By studying the area displayed on the monitor, your surgeon can cut away and remove the affected lobe.

Note that the surgery is completed without cutting through the sternum and separating the ribs. Consequently, there are fewer complications and less pain during recovery.

Determining Candidacy For Minimally-Invasive Lung Cancer Surgery

Not all patients are suitable candidates for minimally invasive lung cancer surgery. As a general rule, those with small tumors near the outer edge of the lung make better candidates. Also, a VATS lobectomy is only possible if the disease can be detected while it is in its early stages. Once it spreads beyond the lungs (i.e. it metastasizes), other treatment measures become necessary.

As long as a medical center offers this approach to lung cancer surgery, it is considered for all patients. Your doctor - and an oncologist - will ultimately decide whether your condition makes you a suitable candidate.

Recovering From The Operation

With invasive thoracotomy, you can expect to stay in the hospital for up to ten days. That said, many patients are released as early as five or six days following surgery. With a VATS lobectomy, you may be released after two days, assuming your condition is stable. The recovery time following minimally invasive lung cancer surgery is much shorter than that required after undergoing traditional thoracotomy. Many patients are able to return to their normal activities within three to six weeks.

Reasons Few Surgeons Perform VATS Lobectomy

Not all medical centers offer minimally invasive lung surgery. While the approach has become more widespread over the last decade, many surgeons still lack the necessary skills and training. Relying upon images displayed on a video monitor to perform the removal of a lobe poses a steep learning curve.

If you have been diagnosed with early-stage lung cancer, ask your physician whether a VATS lobectomy represents a viable treatment option. If it does, check whether your doctor's facility can perform the operation. You'll benefit from a faster recovery, less postoperative pain, and a lower risk of complications during the procedure.