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Lobectomy

Each of your lungs has different sections called lobes. The right lung has three lobes, upper, middle and lower, and the left lung has two, upper and lower. A lobectomy is a surgical procedure that is used to remove the lobe where your cancer is located. This type of surgery may be performed to provide you with the best chance for a cure, or to help relieve some, or all of the symptoms of your cancer.

Preparing for Your Lobectomy

A lobectomy is done on an inpatient basis, which means you may have to arrive at the hospital the day before surgery, and will remain in the hospital for a period of time after surgery. As part of preparing for your surgery, the doctor should give you the specifics of when to arrive at the medical facility, and where to check in. He/she should also give you information on how to prepare yourself for the procedure, and what you can expect during and after your hospital stay.

Prior to your surgery, the doctor will ask about any allergies you might have and about any medications you are currently taking, including over-the-counter medications, prescription drugs and vitamins or herbal supplements. He/she will need to know when and how much of each is taken. This is important because you may need to stop taking certain kinds of medicine before surgery. If you smoke, you will be asked to stop. You will also be asked not to eat or drink anything for a certain period of time before surgery.

After surgery, you will need to stay in the hospital for several days. The exact amount of time may vary depending on how quickly you recover and whether any complications arise. You will want to plan to have someone take you to hospital, and when you are released, to drive you home.

The Day of Your Surgery

On the day of your surgery, you may be taken to a preoperative area or directly to the operating room. Every attempt will be made to keep you comfortable, and if you feel anxious, you may be given medication to help you relax.

In preparation for surgery, patches will be put on your chest, arms or legs for an electrocardiogram (EKG) that will monitor the electrical activity of your heart. The medical team will also place a number of tubes and lines in your body for use during and after surgery. You will be given an intravenous fluid line (IV) through which you will be given medications and fluids during surgery, and possibly a second line, called an arterial line that helps check your heart rate and blood pressure.

The Surgery Itself

When it’s time for your surgery, you will be moved to the operating table. Once you are on the table, a blood pressure cuff will be put on your arm, and a wide belt will be placed around you for safety. A pulse oximeter will be taped to your finger to keep check on how much oxygen is in your blood. When you are ready, you will be given anesthesia.

Anesthesia is medicine that keeps you from feeling pain during surgery. For a lobectomy procedure, you will receive what is known as general anesthesia, which means that you will be in a deep sleep, and will not feel pain, pressure or movement. You will be asked to breathe through a mask, and will be given medicine to help you relax so that you quickly fall asleep. After you are asleep, a breathing tube will be placed in your windpipe that will help you breathe during surgery. You will then be turned on your side to make it easier for the surgeon to reach the area of the ribcage where the incision will be made. This area will then be washed with a special disinfectant, and might also be shaved. A catheter (plastic tube) will be placed in your bladder, and a second tube will be placed down your throat and into your stomach.

The surgeon will then make an incision, starting between two ribs and going around to your back. The ribs will be held open, and part of a rib may be removed to make it easier for the surgeon to reach your lung. After locating the tumor, the surgeon will cut the veins, arteries and bronchial tube to that area of the lung, and will remove the lobe containing the cancer from the rest of the lung. Once this is completed, the blood vessels and bronchial tube will be stapled or sewn closed, and the doctor will check for any bleeding in and around the lungs.

After a lobectomy, your lung may leak air and fluid for a while. Although this is considered normal, these accumulations may cause the lung to collapse. In order to prevent this, one or more chest tubes may be inserted to help with drainage and to help your lung stay inflated. After these tubes are in, the rib cage will be closed with heavy-duty stitches, and the skin and tissues underneath it will be closed with additional stitches. Finally, the skin will be stitched closed, and the area covered with a bandage.

Recovering from Your Lobectomy

After your surgery is complete, you will be moved to a recovery area where you will be monitored as you wake up from the anesthesia. If you need to be monitored more closely or for a longer period of time, you may be moved to an Intensive Care Unit (ICU). At this time, the doctor will talk to your family and friends, and they will be allowed to visit at scheduled times. You will rest in either the recovery room or the ICU until the doctors feel you are recovering well, and at that time you will be moved to a hospital room.

After surgery, you may still have breathing tubes, chest tubes or catheters in place. The breathing tube will be removed as soon as the medical team feels that you are able to breathe on your own, in most cases, the same day. Chest tubes will be removed once the air and fluid has stopped leaking from your lung. Time may vary, but generally this process takes three to four days.

You will most likely remain in the hospital from five to seven days after surgery, but this is dependent on how quickly you are recovering. The doctors will give you and your family regular updates on your progress. When you are ready to leave the hospital, the doctors will give you specific instructions on how to take care of yourself. This should include information on safe activity levels, medications and any symptoms that might mean you need to return to the hospital. Your first follow-up visit with the doctor will also be scheduled.