Lobectomy

A lobectomy is a surgical procedure where one of the lobes, or sections, of the lungs is removed. This procedure is often performed to treat lung cancer, though it may also be necessary for other conditions such as severe infection, abnormalities, or other lung damage.

There are five lobes in your lungs—three in your right lung, and two in your left lung. During a lobectomy, the surgeon removes the affected lobe of the lung, along with any nearby lymph nodes that may have also been affected. The remaining healthy lung tissue takes over the function of the removed lobe, allowing you to breathe normally after recovery.

Doctors called thoracic surgeons perform lobectomies. At Penn Medicine, we have an active thoracic surgery program—lung cancer surgeries are what we do every day. Our experienced thoracic surgeons have successful surgical track records that cover decades of medical practice and have the expertise to handle even the most complex lung surgeries.

Your Penn Medicine provider may recommend a lobectomy if you've been diagnosed with a serious lung condition that can't be effectively treated with less invasive methods. For example, a lobectomy may be used to treat:

• Early-stage lung cancer: Patients with early-stage, non-small-cell lung cancer or small-cell lung cancer who have a tumor in one lobe of the lung may be a candidate for lung cancer surgery.
• Lung metastases: In some cases, lung lobectomies may be performed to remove metastatic tumors that have spread to the lung from other parts of the body, such as the breast, colon, or prostate.
• Lung infection: Patients with a severe lung infection that affects one lobe of the lung may require a lobectomy if antibiotics or other treatments have been ineffective.
• Lung diseases: Individuals with certain lung and pleural diseases, such as severe emphysema or tuberculosis, may undergo a lobectomy if the disease is only in one lobe and causes significant symptoms or complications.
• Lung volume reduction surgery: In some cases of severe emphysema, a lobectomy may be performed to improve lung function and relieve symptoms.
• Pulmonary nodules: Patients with suspicious clumps of cells or masses found on imaging tests may undergo a lobectomy for diagnostic purposes or to remove potentially cancerous tissue.

Candidates for a lobectomy undergo a thorough evaluation by a multidisciplinary team of Penn Medicine professionals, including surgeons, oncologists, pulmonologists, and radiologists, to determine the most appropriate treatment plan for your specific situation.

Before your lobectomy surgery, your doctor will explain how the procedure is done and give you time to ask questions. Your care team will review your medications with you, discuss your health history, and let you know how to prepare for surgery. You may also be required to have preoperative tests and evaluations—such as imaging, heart, or lung tests—to assess your overall health for surgery.

A lobectomy can be performed through traditional surgery, video-assisted thoracoscopic surgery (VATS), or robotic-assisted thoracoscopic surgery (RATS). Penn Medicine surgeons use the least invasive methods possible, which allows for smaller incisions, less pain, and a faster recovery.

On the day of your procedure, you can expect the following:

• You'll have anesthesia with sedation, so you're asleep and pain-free during surgery.
• The surgeon will make an incision on your chest wall and carefully separate the tissues and structures surrounding the affected lobe to gain access to the lung.
• The surgeon will separate the blood vessels, airways, and other structures leading to and from the affected lobe. The lobe will then be gently removed, and the surgeon will ensure that the remaining lung tissue is functioning properly.
• The incision will be closed using sutures or surgical staples, and chest tubes may be placed to drain any excess fluid or air from the chest cavity.
• After the surgery, you'll be monitored closely as you wake up from anesthesia. Pain management and respiratory therapy will be provided to help you recover and regain lung function.
• You'll stay in the hospital for several days, depending on the extent of the surgery and your overall health.
• To help regain your strength, mobility, and lung function, you may participate in physical therapy, breathing exercises, and pulmonary rehabilitation.

Once you go home, it's important to attend all your follow-up appointments with your surgical team so they can monitor your recovery, assess your lung function, and discuss any further treatment or additional care that may be needed.

Recovery from lung lobe removal can vary from person to person and may take several weeks to months. The incision area may be sore for a few days, and deep breathing and coughing can cause your chest and shoulder to ache. Your Penn Medicine provider will talk with you about pain management options. Depending on the extent of the surgery and your overall health, recovery may involve rehabilitation to regain full lung function.

Remember to be patient with yourself and give your body the time it needs to heal. If you have concerns or questions during your recovery, don't hesitate to contact your Penn provider for guidance and support.

Our lung cancer program features nationally recognized experts with extensive experience in diagnosing and treating lung cancer and related disorders. When you work with us, you can expect:

• Precise tumor detection: TumorGlow® uses an injectable dye that makes tumors more visible to surgeons. This technique, developed at Penn Medicine, allows for greater accuracy in removing the entire tumor and reduces the odds of follow-up surgery.
• Advanced technology: We use the latest technology to create treatment plans and perform lung cancer surgeries. By using state-of-the-art tools, we can identify and remove cancerous tissue that is often missed by less advanced imaging.
• Lung-sparing surgery: When possible, we do procedures like sleeve lobectomies to save part of your lung while removing the affected lobe. We are among the few institutions in the southeastern Pennsylvania and New Jersey regions able to perform these procedures.
• Elevated care before and after surgery: Our Enhanced Recovery After Surgery (ERAS) program promotes a positive experience and quick recovery after lung surgery. Focused on ensuring that you're as healthy as possible before and after surgery, it's the only program of its kind in the region.