Lung Cancer Surgery
Procedures done to sample lymph nodes and determine the stage of lung cancers
- Bronchoscopy with Endobronchial ultrasound (EBUS): Bronchoscopy involves putting a flexible camera down the mouth and into the airways. A camera with an ultrasound probe is used for EBUS. This allows the surgeon to see lymph nodes through the windpipe and biopsy them with a needle. There is no incision, and this is done as an outpatient.
- Cervical Mediastinoscopy: Mediastinoscopy involves making a small incision in the neck and directly removing lymph nodes from around the windpipe, using a camera. It does require an incision, but is also done as an outpatient. Mediastinoscopy has the advantage of getting large pieces of lymph nodes for analysis.
Surgical excision of lung cancer is usually indicated in early stage lung cancer, sometimes in combination with chemotherapy and radiation. Depending on the location of the tumor, the size of the tumor, and how good the lung function of the patient is, different types of lung resection may be recommended. The mainstay of lung cancer surgery is lobectomy, or removal of a lobe of the lung. A lobe is usually between 10-25% of the lung. This, as well as other types of lung cancer surgery, can be done through a thoracotomy (incision between the ribs), with thoracoscopy (using three small incisions and a video camera, also known as VATS), or using robotic-assisted surgery. Lymph nodes within the chest are typically removed at the time of surgery.
- Lobectomy: Removal of an entire lobe of the lung (10-25% of the lung)
- Segmentectomy: Removal of a segment of a lobe of the lung (5-20% of the lung)
- Wedge Resection: Removal of a piece of lung (smaller than a segment)
- Pneumonectomy: Removal of the entire lung on one side
- Sleeve Resection: Removal of part of the airway with or without the lobe of the lung and sewing the airway back together. This procedure is most commonly done to avoid removing the entire lung.