Lung Cancer Surgery: A Guide For Patients
Lung Cancer Surgery: A Guide For Patients
Lung cancer is one of the most common and deadliest forms of cancer in Australia, impacting thousands of lives every year. It is a significant health issue that has called for continuous research, innovative treatment methods, and comprehensive patient education. In this post, we’re going to focus on the role of surgery in lung cancer treatment.
What is Lung Cancer?
Lung cancer begins in the lungs and may spread to lymph nodes or other organs in the body. It primarily occurs when cells in the lungs develop errors (mutations) in their DNA. These mutations cause the cells to grow and divide at an uncontrolled rate, leading to the formation of a tumor. If left untreated, these cancerous cells can spread beyond the original tumor to other parts of the body.
Lung Cancer in Australia
Australia has a significant incidence of lung cancer. According to the Australian Institute of Health and Welfare, lung cancer is the fifth most common cancer but ranks highest in terms of mortality. Smoking is the most common risk factor, but non-smokers can also develop lung cancer.
Understanding Lung Cancer Surgery
Surgery is often considered the best option for early-stage lung cancer, where the disease has not spread beyond the lungs. The principal goal of surgery is curative intent, by removing the tumour and the surrounding lung tissue that may be affected by the lung cancer. Understanding the different surgical techniques and procedures can help demystify the treatment process for lung cancer.
There are several types of surgery used to treat lung cancer:
- Lobectomy: This is the most common type of surgery for lung cancer, where the surgeon removes a lobe of the lung that contains the tumour.
- Segmentectomy or Wedge Resection: In this procedure, the surgeon removes a smaller portion of the lung that contains the tumor, usually for smaller tumours or patients with poorer lung function.
- Pneumonectomy: This is a more extensive procedure where the entire lung is removed. It's typically considered when the tumour is centrally located or involves most of the lung.
- Sleeve Resection: This procedure is undertaken when a tumour is located close to the main airways supplying the lung. It involves the removal of a section of the main bronchus to preserve more lung tissue.
Once the type of lung resection is determined, the next step is to decide on the surgical approach. Two main approaches are used in lung cancer surgery: Video-Assisted Thoracoscopic Surgery (VATS) and Thoracotomy.
The evolution of minimally-invasive lung surgery mean patients today now have access to the state-of-the-art technology: Robotic-Assisted Thoracoscopic Surgery (RATS), using the Da Vinci Xi system.
Robotic-Assisted Thoracoscopic Surgery (RATS)
Robotic‑assisted thoracoscopic surgery (RATS) is the latest advancement in minimally invasive lung surgery.
How Does the da Vinci Xi Robot Work?
Robotic lung surgery is still performed through small keyhole incisions, just like VATS (video-assisted thoracoscopic surgery). However, instead of holding the instruments by hand, your surgeon controls them from a console using robotic arms with advanced precision and flexibility. A high-definition 3D camera gives a magnified view inside the chest, allowing delicate structures to be seen and preserved more clearly. This level of visual fidelity and surgical dexterity is unparalleled and enables a level of precision beyond that possible with VATS technique.
Robotic-assisted lung surgery: The Benefits
Compared to traditional VATS surgery, robotic-assisted lung surgery with the da Vinci Xi may offer:
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Greater precision – robotic arms can move more like a human wrist, helping your surgeon operate in tight spaces and near critical structures with enhanced control, ensuring a safer operation for you
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Better lymph node removal – Robot-assisted (RATS) thoracoscopic surgery enables the removal of more mediastinal lymph nodes at the time of lung cancer surgery. This is a vital part of cancer surgery that facilitates accurate cancer staging and improves long-term outcomes
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Less bleeding and fewer complications
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Shorter hospital stay – most patients are home within a few days
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Faster recovery and less pain
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Robotic lung surgery: Is it Safe?
The first robot-assisted lung surgery (lobectomy) was performed in 2001 using the da Vinci system. The da Vinci robot is the most widely used robotic platform internationally and has been adopted widely across many surgical specialties, including thoracic lung surgery.
The current fourth generation da Vinci Xi represents the most advanced robotic technology currently available and has been extensively studied to ensure its safety and efficacy in lung cancer outcomes.
Dr Cheng He is a robot-certified minimally-invasive lung cancer surgeon on the Gold Coast. Please arrange a consultation with Dr He to discuss if robotic lung surgery is suitable for you.
Video-Assisted Thoracoscopic Surgery (VATS)
VATS is a minimally invasive surgical technique used to diagnose and treat lung cancer. This technique uses a thoracoscope (key-hole camera). It is inserted through small, key-hole incisions in the chest, allowing the surgeon to visualise and operate on the lung thereby avoiding a large incision.
VATS lung surgery offers several benefits:
- Less postoperative pain: Smaller incisions generally mean less discomfort after surgery.
- Shorter hospital stay: Patients who undergo VATS often leave the hospital earlier after surgery.
- Quicker recovery: The overall recovery time is shorter with VATS, allowing patients to return to normal activities more quickly.
- Fewer complications: The risk of complications such as infections and lung complications can be lower with VATS.
- Improved aesthetics: key-hole incisions offer better cosmetic results by minimising the length of the surgical wound
Thoracotomy
Thoracotomy is a traditional surgical approach where the surgeon makes a larger incision in the chest to access the lungs. This approach gives the surgeon a direct view and more room to work, which can be beneficial in complex cases or when the tumor is large or centrally located.
Here are some key points to consider about thoracotomy:
- Longer recovery period: As this approach involves a larger incision, the recovery period is usually longer than with VATS. It might take several weeks or even months for a patient to fully recover.
- More discomfort after surgery: Patients may experience more pain after surgery, but this can be effectively managed with medications. The use of regional anaesthetic agents and/or the use of cryo nerve block help to mitigate the degree of discomfort postoperatively.
- Longer hospital stay: Patients generally need to stay in the hospital for a longer period after a thoracotomy.
Making the Right Choice
The choice of procedure and surgical approach depends on several factors, including the size, location, and stage of the cancer, as well as the patient’s overall health and lung function. The goal is always to choose the approach that will provide the best outcome and quality of life for the patient.
Conclusion
Understanding the role of surgery in lung cancer and the different approaches used can help navigate your treatment journey with greater confidence. It’s crucial to maintain an open dialogue with your healthcare team, ask questions, and express any concerns or thoughts you might have.
You are not alone in this journey. If you or your loved one is seeking trusted expertise regarding lung cancer treatment, please arrange an appointment with Dr Cheng He, Gold Coast consultant cardiothoracic (heart and lung) surgeon. Together with a multi-disciplinary specialist lung cancer team, Dr He will support you every step of the way.
Dr Cheng He
For all appointments
Phone (07) 5353 2000
Email [email protected]
Fax (07) 5353 2001
Mail PO Box 179, Griffith University QLD 4222
Arrange you consultation
To make an appointment with Dr He please contact us via phone, e-mail or fax.
Your consultation
During the initial consult a detailed medical history and physical examination will be performed. Treatment options will be discussed with you. Dr He will help explain the risks and benefits of each option so that you’re empowered to make the next step.
On the day of your consultation, please bring:
- Referral letter from your doctor, if available
- Relevant X-rays, CT/MRI/PET scans, Angiogram, Echo
- Copies of hospital discharge summaries, operation records
- List of current medications
- Medicare/DVA/Pension/Private Health Fund cards
Arrange your consultation
To make an appointment with Dr He please contact us via phone, e-mail or fax.
Most outpatients will have a referral letter from their general practitioner or medical specialist. If you do not have one we can guide you through this process. Please don’t hesitate to contact us.
