Lung Cancer Surgery

City of Hope is ranked among the Highest Performing Hospitals for Lung Cancer Surgery by U.S. News & World Report 2023-24
Surgery on the lung is delicate, and preserving as much tissue as possible requires both experience and skill.
Experienced City of Hope thoracic specialists perform advanced procedures not available at other centers — and are among the best when it comes to high-quality, minimally invasive thoracic surgery for lung cancer.
Additionally, our surgical team includes highly trained leaders in lung surgery who regularly take on complex cases — including some deemed untreatable at other facilities.

Staging Procedures

The following procedures 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.

approaches to Lung Surgery

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 to 25 percent 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 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.

Types of Lung Surgery

  • Lobectomy: Removal of an entire lobe of the lung (10 to 25 percent of the lung)
  • Segmentectomy: Removal of a segment of a lobe of the lung (5 to 20 percent 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.