Lobectomy

Physicians use several types of lung surgery to combat cancer and other cardiopulmonary conditions. A wedge resection is a surgical procedure for removing a tumor, along with a triangle-shaped wedge of tissue surrounding it. A lobectomy is more extensive. In this procedure, the surgeon removes at least one complete lobe from either lung (the right has three, the left has two). A segmentectomy falls between, extracting more tissue than a wedge resection but less than a lobectomy. Lung procedures are considered major surgery. Longer-than-average times are required for both the operation and the recovery period.

Lung procedures are used to address a number of medical conditions, including:

• Cancer
• Chronic bleeding
• Damage from radiation, pollutants, or chemical exposure
• Infectious diseases
• Non-cancerous abnormalities 

Lobectomies and the other lung procedures are performed by means of traditional surgery, video-assisted thoracoscopic surgery (VATS), and robot-assisted thoracoscopic surgery (RATS). In a robot-assisted procedure, the medical team uses sophisticated tools that replicate human movement and boost surgical success. Robot-assisted lung surgeries are performed at Baptist Health facilities in Kentucky and Indiana.

Who Is a Candidate for Robot-assisted Lung Surgery?

Lung health is critical to human health. The lungs are the primary engine of the respiratory system, driving the body’s energy production by introducing oxygen to the bloodstream and removing and releasing carbon dioxide, a waste product of metabolism. The lung’s central importance has led to substantial investments in innovative surgical techniques, including thoracoscopy – laparoscopy for the lungs and chest (the thoracic cavity).

Many lung surgeries are now performed as laparoscopic procedures. This includes those assisted by robots. Wedge resections are helpful in the removal of small tumors, especially with non-small cell lung cancers. They’re also utilized in the treatment of unrelated pulmonary conditions such as emphysema and tuberculosis.

Laparoscopic lobectomies are performed to treat patients with evidence of:

• Cancers of the neuroendocrine cells (carcinoid cancers)
• Infections of a single lobe
• Non-small cell lung cancers (stages I-III)
• Small cell lung cancers (stage I) 

More complex conditions may require traditional surgery.

Your physician will determine your suitability for lung surgery by analyzing your medical history, conducting a physical exam, and ordering a number of tests. These might include bloodwork, breathing tests, an electrocardiogram or EKG, a medical-imaging scan such as an X-ray or a computed tomography (CT) scan, and biopsies. If your condition warrants it, you will be scheduled for a procedure. You will be asked to refrain from eating or drinking for several hours prior to the operation.

Benefits of Robotic Surgery

It is important to note that a robotic procedure does not mean being operated on by a mechanical man rather than a fellow human. Robotic procedures are robot-assisted procedures, where the robot is a group of tools used by a surgeon and his or her medical team to aid in an operation. These tools are called robots because they mimic human motions and movements, sometimes with greater precision and less fatigue than we’re capable of.

A robot-assisted lobectomy is a minimally invasive procedure typically involving three or four minor incisions. One incision might be a little larger to facilitate the withdrawal of lung tissue. Unlike traditional surgery, there is no need to spread or possibly damage the ribs. Robotic surgery offers the following benefits:

• Smaller incisions than with open surgery, and therefore less blood loss
• Reduced scarring
• Lower risk of infection
• Decreased post-surgical pain
• Shorter hospital stays
• Quicker recovery times
• Faster return to normal living 

How Do Robot-assisted Lung Procedures Work?

At Baptist Health, robot-assisted lung procedures are performed with the aid of the Intuitive da Vinci system. Intuitive is a leading American manufacturer of medical robots and related equipment.

The Intuitive da Vinci system has three parts:

• a multi-armed robot for making incisions and inserting cameras and other surgical instruments in the patient
• a vision cart with endoscopic monitors that provide the surgeon with magnified, three-dimensional, real-time images of the surgical site within the body
• a computerized panel from which the surgeon controls the robot and performs the procedure 

A robotic lung procedure is conducted similarly to laparoscopic and other forms of minimally invasive surgery. The robot makes tiny incisions for the insertion of a three-dimensional camera – the surgeon’s eyes during the procedure – and other operating instruments for the detachment and removal of lung tissue. However, a robot-assisted procedure has the advantage of greater precision than a human operating alone because robot technology downscales the surgeon’s hand motions to extremely fine movements, reducing the possibility of organ or tissue damage.

Joining the surgeon and the robot in the operating room are the entire surgical team, including the anesthesiologist, the nurses, and a second surgeon or surgical assistant for moving the robot into positions that aren’t mechanically controlled. A robot-assisted procedure is typically one to three hours in duration.

What to Expect with Robot-assisted Lung Procedures

The surgical procedure will take place with you lying on your back. You will be given anesthesia, so that you’ll be unconscious the whole time. An inpatient stay of two to three days is common following minimally invasive lung surgery. You will have one or two drains in your chest until you go home. These are to remove excess fluid and air from your chest cavity.

Depending on the extent of surgery, you can expect a recovery period of two to four weeks at home. To avoid the possibility of blood clots, you should begin light physical activity shortly after your return. Avoid heavy lifting for at least a month following the procedure.

You may experience some pain following surgery. You will be given pain-relief medication while you remain in the hospital and a time-limited prescription after your return home. As you heal, you should be able to manage any remaining discomfort with over-the-counter products. If your pain is severe, or if you have other serious symptoms, contact your physician immediately. Be sure to schedule a follow-up visit with your physician.

Know Your Risk

Baptist Health is committed to being a leading medical provider of robot-assisted diagnosis and surgery in Kentucky and Southern Indiana. If you have questions or concerns about your cardiopulmonary health, contact your Baptist Health primary care provider.