
Today there are two ways by which the lobe of the lung may be removed. The conventional method includes opening the back and side of the thorax while spreading out the ribs. In this way the thoracic cavity can be entered and the diseased lobe or lung cut off together with the lymph nodes at all points around the heart.
During the last decade, a minimally-invasive technique has become a common method for removal of a lobe only. This method is performed by introducing a miniature television camera into the chest cavity, together with other three or four minimal entries to sever the affected lobe. It is important to note that this technique is intended only for patients with small tumors that are located in the lungs.
Surgery is performed under general anesthesia. In addition, the anesthesiologist inserts an epidural catheter that will be used for several days after surgery.
During the first couple of days sedation is administered through an epidural catheter and the patient feels great relief. Duration of surgery is usually about an hour and a half, with patients spending their first night after surgery in the intensive care unit, even though they are fully conscious with spontaneous breathing. At the end of the operation a trocar or two will be seen exiting from the patient's chest, and they will remain there for several days. After removal of the draining trocars epidural anesthesia is stopped, and pain management is administered by oral medications.