Lung Cancer Surgery
Surgery is one of several approaches used to treat lung cancer. The type of surgery—or whether surgery is indicated at all—will depend on the type, location and stage of the cancer, as well as the patient's overall medical health.
We're ranked in the top 1% of all hospitals in the nation for cancer care according to U.S. News & World Report. Our multidisciplinary approach allows us to develop personalized treatment plans to ensure the highest level of cancer care and optimal outcomes. Our surgeons collaborate with pathologists, radiologists, medical oncologists and experts at Montefiore Einstein Comprehensive Lung Program and the Division of Pulmonary Medicine to determine each patient’s options for care. Surgery may be used for diagnosis or treatment of lung cancers.
Biopsy Procedures
A biopsy removes a section of tissue so that it can be examined under a microscope for signs of disease. A lung biopsy can be performed in several ways: using a bronchoscope, a needle, open surgery or video-assisted thoracoscopic surgery (VATS). The method used depends on where the sample will be taken from and your overall health.
Biopsy of other tissues may also be included as part of evaluation and diagnosis. Lymph node biopsy uses a fine needle, a special core needle or open surgery to remove lymph node tissue. Mediastinoscopy uses a mediastinoscope to examine the thoracic cavity for tissue sampling, mediastinal lymph node biopsy and staging. Pleural biopsy uses a needle to remove a portion of the thin tissue that lines the lungs and chest cavity.
Surgical Approaches
Lung cancer surgery is recommended when the cancer is contained to one area and has not likely metastasized, such as early-stage non-small cell lung cancers and carcinoid tumors. Not all lung cancers can be treated with surgery.
Lung surgery generally involves removing the tumor along with a portion of adjacent lung tissue and often the associated lymph nodes. It may be performed through open surgery (thoracotomy) or minimally invasive surgery (robotic-assisted or video-assisted thoracoscopy).
Thoracotomy involves open surgery that takes place through an incision cut between the ribs. An instrument is used to open the incision to provide the surgeon with unobstructed access to the lungs.
This surgical approach enables doctors to view the organs inside the chest to check for abnormal areas, and it may also be used to remove tissue or lymph node samples. Small incisions (cuts) are made between the ribs. The robotic surgical system has multiple tiny instruments including a thoracoscope: a thin, tube-like instrument equipped with a light and a camera. The robotic system is fully controlled in real-time by the surgeon in the room and provides the surgeon with a clear, magnified view of the area and greater precision.
This state-of-the-art, minimally invasive surgery enables doctors to view the organs inside the chest. Small incisions (cuts) are made between the ribs and a thoracoscope (a thin, tube-like instrument equipped with a light and a camera) is inserted into the chest, which provides the surgeon with a clear, magnified view of the area and ensures greater precision.
Types of Surgical Procedures
There are many surgical procedures that may be used to remove tumors and adjacent tissue. The name of the surgery reflects the type of tissue being operated on or removed:
Each lung is divided into sections called lobes. A bilobectomy involves the removal of two lobes of the right lung when tumors are present in two adjacent lobes.
This surgical procedure removes a diseased portion of the chest wall.
This is a surgical procedure to remove a portion of the esophagus.
Each lung is divided into sections called lobes. It is recommended when cancer is present in a single lobe. This surgical procedure removes the cancer-affected lobe of the lung.
This surgical procedure removes the lymph nodes in the area between the lung and the chest.
This is a surgical procedure to remove the entire lung when cancer has affected several lobes.
This is a surgical procedure to remove tumors that are located on the chest wall.
This surgical procedure removes more lung tissue than a wedge resection butless tissue than a lobectomy to preserve tissue that is unaffected by cancer.
This surgical procedure is used in the treatment of lung cancer that affects both one lobe of the lung and the main bronchus to that lung. The cancerous lobe and a portion of the main bronchus are removed. The remaining end of the main bronchus is rejoined with the bronchus to unaffected lobes. This surgery avoids the need for a pneumonectomy.
This surgical procedure removes a damaged or diseased portion of the trachea.
Tunneled pleural catheters (IPCs) may be placed in patients who experience buildup of fluid around the lungs (pleural effusions) associated with cancer. Tunneled pleural catheters are soft silicone tubes that allow patients to better manage shortness of breath resulting from recurrent malignant pleural effusions.
This surgical procedure removes a small wedge-shaped portion of the lung surrounding a tumor.
Side Effects
Every surgery has its own risks and potential side effects. Some surgeries are associated with specific complications, pain or physical limitations after surgery.
Talk to us about your concerns. Each patient’s priorities become our priorities in evaluating options for cancer care, be it surgery, radiation therapy, chemotherapy, or a combination of several approaches. By understanding your personal concerns and care goals, we can ensure that you are fully informed, have access to comprehensive options, and remain at the center of your own care.