Video-assisted lobectomy in Turkey

Video-assisted lobectomy

Video-assisted lobectomy as a type of minimally invasive thoracic surgery

Lung cancer is the leading cause of cancer death in the United States, with approximately 180,000 new cases diagnosed each year.

Whereas surgical removal offers the best chance of recovery for those affected lung cancer In its early stages, the traditional open chest approach (called a thoracotomy) usually requires a five to seven day hospital stay, with an extended recovery period at home.

Thoracic surgeons offer a less invasive technique called video-assisted lobectomy to selected patients as a treatment for early-stage lung cancer.

Video-assisted thoracic surgery (VATS) reduces a patient's stay in the hospital for about three to four days and the patient experiences less pain and a faster recovery after video-assisted thoracotomy compared to the traditional incisional thoracotomy approach.

Lobectomy or pulmonary masses by VATS video thoracic surgery
Pulmonary mass resection via video thoracic endoscopic surgery (VATS)

What is a lobectomy?

A lobectomy is the surgical removal of a large part of the lung.

A lobectomy is the most common surgery performed to treat lung cancer.

A lobectomy is traditionally performed during thoracotomy surgery (thoracotomy means traditional surgical incision in the chest).
During thoracotomy, an incision is made on the side of the chest between the ribs.
Then the ribs separate so that the surgeon can see the chest cavity and remove the tumor or affected tissue.

Procedure details

What tests are required before a video-assisted lobectomy?

If lung cancer is found, further tests will be done to see if cancer cells have spread from one or both lungs to other parts of the body.

Your doctor needs to know the stage of the disease to plan your treatment.
Preoperative exams usually last about a day and are scheduled a few weeks before surgery.
The thoracic surgery schedule will determine the dates of the tests and consultations your surgeon has requested.

Generally, after your first meeting with your surgeon, all exams are scheduled in one visit for your convenience.

Preoperative tests include:

  • A complete physical examination.
  • Chest X-ray.
  • Computed tomography (CT).
  • Positron emission tomography (PET) scan.
  • Blood tests.
  • Electrocardiogram or cardiac stress test.
  • Breathing tests, such as spirometry or a lung function test.

Your surgeon will determine if any other tests are needed before surgery.

As part of your preoperative evaluation, you will meet with the anesthesiologist, who will discuss anesthesia and pain management after surgery.

What happens during a lobectomy using video-assisted thoracic surgery (VATS)?

Video-assisted lobectomy is less invasive than traditional thoracotomy.

During a lobectomy using video-assisted thoracic surgery, three 1-inch and 3- to 4-inch incisions are made in the chest to provide access to the chest cavity without spreading the ribs.

The location of the small incisions made during VATS . video-assisted lobectomy

During a video-assisted lobectomy, a thoracoscope (a small video camera) and surgical tools are inserted into the incisions. The thoracic surgeon is guided by images of the surgical area transferred from the thoracoscope during the lobectomy procedure. The images are displayed on a computer monitor placed next to the patient.

Side vision

The surgeon will remove the tumor or infected tissue from the lung through small incisions. If a cancerous tumor is removed in its early stages, lymph nodes (small bean-shaped structures) in the middle of the chest may also be removed or biopsied to ensure that the cancer has not spread to them.

Before the procedure is completed, the surgeon will check for any areas of bleeding, wash the chest cavity and close the small incisions. One or two drains remain in place after surgery to remove excess fluid and air from around the lung. The drains are removed later during the patient's recovery.

Recovery and future prospects

Your hospital stay after a video-assisted lobectomy is usually 3 to 4 days after surgery. Your thoracic surgery team, including your surgeon, surgical residents, colleagues, surgeons, nurses, social workers and anesthesiologist, will help you recover as quickly as possible.

While you're recovering in hospital, you and your family will receive information about your improvement so you know when you can go home.

Your health care team will provide specific instructions for recovering and returning to work, including instructions for activity, driving, wound care and diet. In general, you may be able to return to work (if you have a stable job), drive and participate in most non-strenuous activities within 4 to 6 weeks after minimally invasive chest surgery. You can resume heavy lifting and other strenuous activities within 6 to 12 weeks after surgery.

A follow-up appointment will be scheduled 7 to 10 days after the surgery. You'll have a chest X-ray and the surgeon will assess the location of the wound and your healing. Your surgeon will provide additional instructions about your activities, return to work and diet at this time.

Common Questions

Patients who require a variety of diagnostic and/or therapeutic procedures for the outer area of the lung may be eligible for video-assisted surgery. Patients with stage I non-small cell lung cancer (a small primary tumor, less than 3 cm in size, in stage I that has not spread outside the lungs) or patients who have had a single lung cancer with an enlarged lung nodule are the best eligible for VALP.

Although minimally invasive methods are considered for each patient, some patients may not be eligible for video-assisted lobectomy. Conventional thoracotomy may be more appropriate for some patients with large tumors with involvement of the lymph nodes involved.

When you meet with your chest surgeon for preoperative evaluation, a physical examination will be done. The surgeon will ask you questions about your condition and health history. Your thoracic surgeon will discuss your treatment options and the potential benefits and risks of the procedure recommended for you. Additional tests will be ordered to make sure that video-assisted lobectomy is the right treatment for you.

Patients who have a video-assisted lobectomy generally experience less pain and recover faster than those who have traditional thoracotomy. Other potential benefits include a reduced risk of infection and reduced bleeding.

Recent research has indicated that video-assisted lobectomy can be performed with low complication rates and shortening the in-hospital recovery period to approximately 3 to 4 days. Additional studies also show that video-assisted lobectomy is just as effective in removing stage I lung cancers as a traditional thoracotomy.

There are risks from every surgery. Your doctor will discuss the potential risks of the procedure with you. Potential risks of this procedure may include:

  • Risk of bleeding that requires opening the chest (thoracotomy).
  • Persistent air leakage from the lung (more than 7 days).
  • Subcutaneous swelling (the presence of air or gas in the tissues under the skin).
  • Fever.

تختلف نسبة نجاح عملية استئصال سرطان الرئة حسب مرحلة السرطان في حين تتجاوز نسبة النجاح في المرحلة الأولى 95% في حين لايمكن استئصال السرطان في المرحلة الرابعة.

تختلف تكلفة عملية استئصال سرطان الرئة في تركيا حسب مرحلة المرض ونوع المشفى والطبيب الذي سيقوم بالعملية ولكن بشكل عام تتراوح بين 7 و 15 ألف دولار أمريكي.

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