A lung lobe is removed surgically in a procedure called a lobectomy, most often through an incision in the chest. Here's a more detailed breakdown of the process:
Surgical Approach
The typical approach involves:
- Incision: The surgeon makes an incision, often on the front of the chest under the nipple, extending around the back under the shoulder blade on the side of the affected lung.
- Rib Access: The surgeon gains access to the chest cavity by carefully separating the ribs. This allows them to visualize and access the lung lobe.
Lobectomy Procedure
Once the chest cavity is open:
- Identification: The surgeon identifies the specific lung lobe that needs to be removed.
- Vascular and Bronchial Dissection: The blood vessels (pulmonary artery and vein branches) and bronchus (airway) leading to the affected lobe are carefully dissected and separated.
- Ligation and Division: These vessels and the bronchus are then ligated (tied off) and divided (cut). This effectively isolates the lobe from the rest of the lung.
- Removal: The isolated lung lobe is then carefully removed from the chest cavity.
- Closure: The remaining lung tissue is checked for air leaks. Chest tubes are inserted to drain air and fluid from the chest cavity, allowing the lung to re-expand. The ribs are brought back into position, and the incision is closed.
Minimally Invasive Techniques
In some cases, a lobectomy can be performed using minimally invasive techniques, such as:
- Video-Assisted Thoracoscopic Surgery (VATS): This technique involves making several small incisions in the chest. A camera and specialized surgical instruments are inserted through these incisions, allowing the surgeon to visualize and remove the lung lobe without opening the chest cavity as widely.
- Robotic-Assisted Thoracoscopic Surgery (RATS): This technique is similar to VATS, but the surgeon controls robotic arms to perform the procedure with enhanced precision and dexterity.
Post-Operative Care
After the lobectomy, the patient will typically require:
- Pain management: Medication to manage pain and discomfort.
- Respiratory therapy: Exercises to help re-expand the remaining lung and improve breathing.
- Chest tube management: Monitoring and care of the chest tubes until they can be safely removed.
