Lobectomy: How to prepare and what to expect

In this video, Dr. Rishendran Naidoo, Director of Cardiothoracic Surgery at The Prince Charles Hospital (TPCH), shares his expert knowledge on what a lobectomy is and how the surgery works. A lobectomy is a surgical procedure that involves removing one of the lobes of the lung. The human lungs are divided into lobes: three in the right lung and two in the left. This procedure is most performed to treat lung cancer, particularly non-small cell lung cancer (NSCLC) in its early stages.

Types of Lobectomies: Dr. Naidoo explains that there are different types of lobectomy procedures, each suited to specific patient needs and tumour characteristics:

• Thoracotomy: This traditional approach involves making a larger incision in the chest wall and spreading the ribs to access the lung. It is typically used for more complex cases where a minimally invasive approach may not be feasible.
• Video-Assisted Thoracoscopic Surgery (VATS): This minimally invasive technique involves making small incisions between the ribs to insert surgical tools and a camera. The surgeon performs the operation from outside the chest, guided by the video feed.
• Robot-Assisted Thoracoscopic Surgery (RATS): Like VATS, this method uses robotic technology to enhance precision and control during the surgery.

Eligibility for Surgery: Eligibility for a lobectomy depends on several factors, including the type and stage of lung cancer, the size and location of the tumour, and the patient’s overall health and lung function. Patients typically undergo a series of tests, such as physical exams, chest X-rays, CT scans, PET scans, and pulmonary function tests, to determine their suitability for surgery.

Potential Risks and Side Effects: Dr. Naidoo discusses the potential risks and side effects associated with a lobectomy. While the immediate or early risks are generally low, around 1-3%, they can include infection, pneumothorax (collapsed lung), bleeding, bronchopleural fistula (air or fluid leak), empyema (pus in the chest cavity), and pleural effusion (fluid in the chest cavity). Post-surgery, patients may experience pain, fatigue, and breathing difficulties, which typically improve over time. Pain management and breathing exercises are crucial components of the recovery process.

Recovery Process: Recovery from a lobectomy involves a hospital stay of a few days, followed by several weeks of at-home recovery. Patients are usually on oral pain relief and may need stronger medication as their activity levels increase. Breathing exercises and physiotherapy are essential to aid lung function and prevent complications. Full recovery can take at least a month, with some patients experiencing chest discomfort, tightness, or numbness for several months post-surgery.

For further information and support, patients and carers can contact the Lung Foundation Australia’s Information and Support Centre on free call 1800 654 301 or book a call through their website at lungfoundation.com.au/support. This service provides access to specialist nurses, support groups, and educational materials to help manage the challenges of living with lung cancer and navigating the treatment process.