Surgical Management

Types of Lung Operations

Structure of the lungs:
The lungs consist of Lobes

3 on the right
(Upper, Middle and Lower)

and 2 on the left
(Upper and Lower)

Operations Performed:

Lobectomy - a complete lobe of the lung is removed
Sleeve Lobectomy - the windpipe to the right upper lobe is removed with the right upper lobe. The windpipe is joined back up again. This preserves the middle and lower lobe.
Pneumonectomy - removal of the whole lung.
Wedge Resection - a triangle of the lung is stapled out, incorporating the cancer.
Resection incorporating the overlaying ribs - If the tumor is stuck to the ribs, they are removed with the lung-tissue by cutting across them behind and in front of the tumor. If several ribs are to be removed the defect is patched with nylon mesh and bone cement. If the defect lies under the shoulder blade, usually no patch is necessary.

Incisions used:

Posterolateral Thoracotomy - the ribs are separated after the muscles round the chest are divided. Rarely is a rib removed for access. As the ribs are separated they hinge at the front and back and are likened to two bucket handles being separated.