Lung Surgery

We treat many lung conditions with surgery. You may need surgery if you have:

• Lung cancer.
• Pleural mesothelioma.
• Abnormal growths like pulmonary nodules.
• Benign lung tumors.
• Pulmonary hypertension.
• Damaged lung tissue from emphysema, cystic fibrosis (CF) or interstitial lung disease (ILD).

Before we craft your personalized surgery plan, it’s important to understand more about your specific condition. That’s why we’ll have you come in for a pre-surgery evaluation. The evaluation helps us get to know you and understand what’s been going on. During this visit, your provider may ask:

• What symptoms do you have?
• How long have you had symptoms?
• How do these symptoms affect your life?
• Do you have other health conditions?

You’ll also have a physical exam during this appointment. And your provider will order tests to help them confirm a diagnosis and plan treatment.

Tests you may have before lung surgery

We use tests to see how well your lungs work and to look for signs of damage, blockages, tumors and more. You may have:

• Biopsy to test for cancer.
• Blood oxygen level tests (pulse oximetry).
• Blood tests to rule out other conditions.
• Bronchoscopy to collect lung fluid and tissue samples for testing.
• Chest X-ray or CT scan to look inside your lungs.
• PET scan to look for signs of cancer.
• Lung (pulmonary) function tests to see how well your lungs work.
• Thoracoscopy to look inside your lungs and get tissue samples for testing.
• Mediastinoscopy to check the area between your lungs for signs of cancer.
• Electrocardiogram (EKG) to make sure your heart is healthy enough for surgery.

Meet Our Lung Surgery Team

If you choose Cleveland Clinic for your lung surgery, you’ll get care from a team of skilled providers from different specialties. This team works closely together to plan the most personalized and effective treatment for you. You may see:

• Cardiothoracic surgeons.
• Pulmonologists.
• Radiologists.
• Pathologists.
• Anesthesiologists.
• Respiratory therapists.

The kind of lung surgery you’ll have depends on your diagnosis and overall health. Your care team uses the information from your physical exam and tests to choose the best surgery for you.

Lung resection

Each of your lungs has sections called lobes. Your larger right lung has three lobes. The smaller left one has two. A lung resection removes part or all of these lobes or your entire lung. There are different kinds, like:

• Lobectomy: This surgery removes a single lobe.
• Bilobectomy: We remove two lobes of your right lung while preserving the remaining lobes.
• Wedge resection: We remove a wedge-shaped section of abnormal lung tissue from your lung.
• Segmentectomy: Our team removes between one and four parts of your lung’s lobe, preserving the rest.
• Pneumectomy: Our surgeons remove your entire right or left lung.

When we can, we’ll use minimally invasive or robotic surgery. Minimally invasive lung resection is known as video-assisted thoracoscopic surgery (VATS). The robotic version is called robot-assisted thoracoscopic surgery (RATS).

These methods use tiny incisions (cuts), a camera and tiny tools. Recovery is usually less painful and shorter compared to having open surgery (thoracotomy). We do open surgery by making a large incision in your chest to reach your lungs.

Lung volume reduction surgery

We do lung volume reduction surgery (LVRS) to remove lung tissue damaged by emphysema. It can help if you have severe shortness of breath (dyspnea) or trapped air in your lungs.

By removing up to 30 percent of each affected lung, it can help your lungs work better. We’ll try to do this surgery using minimally invasive thoracoscopy. But sometimes, we might need to do open surgery called a sternotomy.

Pulmonary thromboendarterectomy

If you have ongoing (chronic) blood clots in your lungs, you may need surgery to remove them — particularly if medications to treat this condition aren’t effective. We do this with complex pulmonary thromboendarterectomy.

During surgery, we’ll put you on a cardiopulmonary bypass machine to take over the work for your heart and lungs. It makes sure your body keeps getting the oxygen it needs. We’ll also cool your body to stop circulation so blood stops flowing through your lungs. The cooling also protects your brain from damage during surgery. We then remove the clots and any scar tissue from your lungs.

When we finish, we warm up your body, remove the bypass machine and keep you on a ventilator. Then, we’ll close the incision, and you’ll go to our intensive care unit (ICU) overnight so our team can keep a close eye on you. The next day, we’ll have you do a breathing test to see if we can remove the ventilator. You’ll stay in the hospital for up to a week and a half (10 days).

Lung transplant

Sometimes, your lungs may be damaged too badly for us to repair them with surgery. And they may not respond to treatment with medications. That’s when we’ll do a lung transplant. In this surgery, we’ll replace one or both of your lungs with healthy ones from a deceased donor. The donor will have a similar lung size and the same blood type as you. Replacing one lung is a single lung transplant — two is a double lung transplant. And in some cases, we may need to do a heart-lung transplant. Recovery from lung transplant surgery can take several months.

Recovering From Lung Surgery at Cleveland Clinic

Recovering from lung surgery can take weeks or months. It depends on the kind of surgery you have and if it was open or minimally invasive.

After lung surgery, you’ll have regular follow-up appointments with your care team. We make sure you’re healing well and do tests to check how well your lungs work.

You may also have pulmonary rehabilitation. This is physical therapy for people with chronic lung conditions or who are recovering from lung surgery. You’ll learn ways to exercise that support your lungs and help you get stronger.

Taking the Next Step

Learning you need surgery can come as a shock, and you might feel stressed and anxious. But sometimes, it’s the only way to treat chronic lung conditions or lung cancer. Our team is here to walk you through everything you need to know about having lung surgery at Cleveland Clinic. We listen to your concerns, answer your questions, and help you understand what to expect. We want you to feel confident about moving forward with treatment and set you on the road to recovery.