Our Summary

This research paper discusses the future of thoracic surgery, which focuses on the organs in the chest. Traditionally, lung surgery required general anesthesia and placing a tube in the patient’s throat to help them breathe. However, advancements in minimally invasive techniques have allowed for major lung surgeries to be performed on patients who are not under general anesthesia. This is made possible through local anesthesia techniques that manage pain, allowing the surgery to be performed while the patient is sedated.

By avoiding general anesthesia, potential side effects such as throat trauma from the breathing tube, lung injury from ventilation, muscle weakness, and post-surgery nausea and vomiting can be reduced. This approach also allows the patient’s body to respond naturally to the changes in lung function during surgery.

However, the surgical team must be prepared to switch to general anesthesia if necessary. This approach along with a single-portal (one incision) technique represents a significant step in minimally invasive surgery. Therefore, education and training programs may be needed for this approach to be offered to more patients in the future. The paper discusses surgical techniques, regional anesthesia techniques, and when to switch from sedation to general anesthesia.

FAQs

  1. What advancements have been made in minimally invasive lung surgery techniques?
  2. What are the potential benefits of avoiding general anesthesia during lung surgery?
  3. What considerations should surgical teams be aware of when performing lung surgery without general anesthesia?

Doctor’s Tip

A helpful tip a doctor might tell a patient about lung surgery is to follow all pre-operative instructions provided by the surgical team. This may include guidelines on fasting before surgery, stopping certain medications, and other preparations to ensure a successful procedure and smooth recovery. It is important for the patient to communicate any concerns or questions they may have with their healthcare team, and to follow post-operative care instructions closely to promote healing and prevent complications.

Suitable For

Patients who may be recommended for lung surgery include those with lung cancer, lung infections, lung nodules, cysts, or tumors, as well as patients with chronic obstructive pulmonary disease (COPD) or other lung diseases. The decision to undergo lung surgery is typically made after a thorough evaluation of the patient’s condition, including imaging tests, pulmonary function tests, and discussions with a multidisciplinary team of healthcare providers.

Patients who are in good overall health, have a strong desire to undergo surgery, and have a good chance of benefiting from the procedure are typically considered good candidates for lung surgery. However, the decision to undergo surgery should be made on a case-by-case basis, taking into consideration the patient’s overall health, age, medical history, and preferences.

In conclusion, the future of thoracic surgery is moving towards minimally invasive techniques that offer benefits such as reduced side effects, shorter recovery times, and improved patient outcomes. Patients who may be recommended for lung surgery include those with lung cancer, infections, nodules, cysts, tumors, COPD, and other lung diseases. The decision to undergo surgery should be made after a thorough evaluation of the patient’s condition and consideration of their overall health and preferences.

Timeline

Before lung surgery:

  • Patient meets with their surgeon to discuss the procedure and potential risks and benefits
  • Patient undergoes pre-operative testing and evaluation to ensure they are a suitable candidate for surgery
  • Patient may undergo breathing exercises or pulmonary rehabilitation to improve lung function before surgery
  • Day of surgery, patient arrives at the hospital and is prepped for surgery, which may include receiving medication to relax or sedate them before entering the operating room

After lung surgery:

  • Patient wakes up in the recovery room and may experience some pain or discomfort
  • Patient is closely monitored for any complications or signs of infection
  • Patient may be given pain medication to manage discomfort
  • Patient undergoes physical therapy to help with breathing and mobility
  • Patient is discharged from the hospital once they are stable and able to care for themselves at home
  • Patient follows up with their surgeon for post-operative care and monitoring of their recovery process.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lung surgery include:

  1. What type of lung surgery is recommended for my condition?
  2. What are the potential risks and complications associated with this surgery?
  3. How long is the recovery process expected to be, and what can I expect during this time?
  4. Will I need to be under general anesthesia for the surgery, or is a minimally invasive approach with sedation an option?
  5. What are the benefits of using sedation instead of general anesthesia for this surgery?
  6. How experienced is the surgical team in performing minimally invasive lung surgeries with sedation?
  7. What factors would require the surgery to be switched to general anesthesia during the procedure?
  8. Are there any specific pre-surgery preparations or restrictions I need to follow?
  9. How will pain management be handled during and after the surgery?
  10. What are the potential long-term outcomes and prognosis following this type of surgery?

Reference

Authors: Gonzalez-Rivas D, Bonome C, Fieira E, Aymerich H, Fernandez R, Delgado M, Mendez L, de la Torre M. Journal: Eur J Cardiothorac Surg. 2016 Mar;49(3):721-31. doi: 10.1093/ejcts/ezv136. Epub 2015 Apr 19. PMID: 25896196