(Thoracotomy, Thoracoscopic Lobectomy, Removal of a Lobe of the Lungs, Lung Surgery)

Procedure Overview

What is a lobectomy?

A lobectomy is a surgical procedure performed to remove one of the lobes of the lungs. The procedure may be performed when an abnormality has been detected in a specific part of the lung. When only the affected lobe of the lung is removed, the remaining healthy tissue is spared to maintain adequate lung function.

A lobectomy is most often performed during a surgical procedure called a thoracotomy (surgical incision of the chest). Other lung surgery procedures that may be performed by thoracotomy include:

  • Pneumonectomy - removal of an entire lung when an abnormality or disease is detected throughout the entire lung

  • Wedge resection - removal of a small section of a lobe when an abnormality or disease involves only a small area of lung tissue

  • Segmental resection - removal of a segment, or subdivision of a lobe

  • Exploratory thoracotomy - opening of the chest wall for direct visualization of the lungs and other chest structures when there is evidence of an abnormality or disease that has not been verified by other diagnostic methods

There are different kinds of thoracotomies depending on the location of surgical entry and how much lung is removed. Generally, during a lobectomy the incision is made at the level of the affected lobe. The incision is made on the front of the chest under the nipple line and extends around the back under the shoulder blade. The surgeon enters the chest cavity through the exposed ribs to remove the lobe.

In certain circumstances, a minimally invasive procedure called video-assisted thoracic surgery (VATS) is used to perform a lobectomy. Specialized surgical instruments are inserted into the chest cavity through three or four small incisions. One of the instruments, a thoracoscope, has a tiny camera and transmits the image to a TV-like monitor. The surgeon is able to view the internal organs on the monitor. Through the remaining incisions, other specialized instruments are inserted and used to perform the procedure. The type of procedure performed will be determined by the surgeon, based on the patient's medical condition and other factors.

Other related procedures that may be used to diagnose problems of the lungs and respiratory tract include lung biopsy, pleural biopsy, bronchoscopy, thoracentesis, and mediastinoscopy. Please see these procedures for additional information.

Anatomy of the respiratory system

The respiratory system is made up of the organs involved in the interchanges of gases, and consists of the:

  • Nose

  • Pharynx

  • Larynx

  • Trachea

  • Bronchi

  • Lungs

The upper respiratory tract includes the:

  • Nose

  • Nasal cavity

  • Ethmoidal air cells

  • Frontal sinuses

  • Maxillary sinus

  • Larynx

  • Trachea

The lower respiratory tract includes the lungs, bronchi, and alveoli.

What are the functions of the lungs?

The lungs take in oxygen, which cells need to live and carry out their normal functions. The lungs also get rid of carbon dioxide, a waste product of the body's cells.

The lungs are a pair of cone-shaped organs made up of spongy, pinkish-gray tissue. They take up most of the space in the chest, or the thorax (the part of the body between the base of the neck and diaphragm).

The lungs are enveloped in a membrane called the pleura.

The lungs are separated from each other by the mediastinum, an area that contains the following:

  • The heart and its large vessels

  • Trachea (windpipe)

  • Esophagus

  • Thymus

  • Lymph nodes

The right lung has three sections, called lobes. The left lung has two lobes. When you breathe, the air enters the body through the nose or the mouth. It then travels down the throat through the larynx (voice box) and trachea (windpipe) and goes into the lungs through tubes called main-stem bronchi.

One main-stem bronchus leads to the right lung and one to the left lung. In the lungs, the main-stem bronchi divide into smaller bronchi and then into even smaller tubes called bronchioles. Bronchioles end in tiny air sacs called alveoli.

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