What tests are needed before video-assisted lobectomy?

If lung cancer has been found, more tests will be done to find out if cancer cells have spread from one or both lungs to other parts of the body (staging). Your doctor needs to know the stage of the disease to plan your treatment. Pre-surgical tests usually last about one day and are scheduled a few weeks before your surgery date. The thoracic surgery scheduler will schedule the tests and consultations that have been requested by your surgeon. In general, after your first meeting with your surgeon, all tests are scheduled on a single returning visit for your convenience.

Pre-surgical tests include:

Your surgeon will determine if any other preoperative tests are needed.

As part of your preoperative evaluation, you will meet with an anesthesiologist who will discuss anesthesia and post-operative pain control.

What happens during VATS lobectomy?

Video-assisted lobectomy is less invasive than traditional thoracotomy. During VATS lobectomy, three 1-inch incisions and one 3- to 4-inch incision are made in the chest to provide access to the chest cavity without spreading of the ribs.

During a video-assisted lobectomy, a thorascope (small video camera) and surgical instruments are inserted into the incisions. The thoracic surgeon is guided by the images of the operative area transmitted from the thorascope while performing the lobectomy. The images are projected onto a computer monitor that is positioned next to the patient.

Position of Small Incisions

Front View

Front View

Side View

Side View

Your surgeon will remove the tumor or affected tissue from the lung through the small incisions. If an early-stage cancer tumor is being removed, the lymph nodes (small, bean-shaped structures) in the mid-chest area may also be removed or biopsied to ensure that the cancer has not spread.

Before completing the procedure, the surgeon will check that there are no areas of bleeding, rinse out the chest cavity and close the small incisions. One or two drains remain in place after the surgery to remove excess fluid and air from around the lung. The drains are removed at a later time during the patient’s recovery.

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