(Lung Surgery; Surgery, Lung)
A thoracotomy is surgery to open the chest. The surgeon will use the smallest opening they can. They may pass a tube with a camera on between the ribs to help them see. This is called video-assisted thorascopic surgery, or VATS.
Reasons for Procedure
This surgery is done to access the chest to diagnose or treat problems of the lungs, aorta, heart, diaphragm, and spine. For example, the opening may be used to:
- Remove tumors or lymph nodes
- Remove blood clots from the chest
- Remove part or all of the lung
- Repair the heart
- Treat a lung that has collapsed due to disease or injury
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Blood clots
- Collapsed lung
- Damage to other organs or structures
- A buildup of air or gases in the chest
Things that may raise the risk of problems are:
- Drinking alcohol
- Long term health issues such as diabetes or obesity
- Major injury to multiple parts of the body
- Past radiation therapy
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from surgery
- Tests that will need to be done before surgery
The doctor will give general anesthesia. You will be asleep.
Description of Procedure
An incision will be made between two ribs. The chest wall will then be opened. A tube will be inserted to drain fluid or air. Any needed procedure will be done at this time. The chest will be closed. The incisions will be closed with stitches or staples. A bandage will be placed over the site.
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How Long Will It Take?
About 3 to 4 hours or longer
Will It Hurt?
Pain is common in the first six weeks. Medicine and home care can help.
For some people the pain does not go away.
Average Hospital Stay
The usual length of stay is 5 to 10 days. You may need to stay longer if there are any problems.
At the Hospital
After the procedure, the staff may:
- Give medicines to help with pain and nausea
- Remove any tubes placed during surgery
- Teach exercises to help with breathing
During your stay, the hospital staff will take steps to lower your risk of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to lower your risk of infection, such as:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others touch your incision
Recovery may take 4 to 6 weeks. Physical activity will be limited during this time. You will need to ask for help with daily activities and delay returning to work.
Problems To Look Out For
Call your doctor if you are not getting better or you have:
- Signs of infection, such as fever or chills
- Redness, swelling, a lot of bleeding, or discharge at the incision site
- Lasting nausea or vomiting
- Pain that you cannot control with medicine
- Problems breathing
- Coughed up mucus that is yellow, green, or bloody
If you think you have an emergency, call for medical help right away.
- Hemothorax. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hemothorax.
- Raveglia, F., Scarci, M., et al. Ultimate management of post thoracotomy morbidities: a set of surgical technique and peri-operative precautions. J Thorac Dis. 2019; 11(3): 370–375.
- Thoracotomy. American Lung Association website. Available at: https://www.lung.org/lung-health-diseases/lung-procedures-and-tests/thoracotomy.
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