TESTS AND PROCEDURES

Thoracotomy

March 21, 2017

Thoracotomy

Side view of male torso showing possible incision site for thoracotomy.

Thoracotomy is surgery used to diagnose and treat certain lung problems. The surgeon makes a cut (incision) through the skin, usually between the ribs, or may remove a rib. He or she then cuts through the lining around the lungs. He or she may take a sample of lung tissue (biopsy). Or the surgeon may take out a tumor or mass, or part or all of a lung. Sometimes surgeons use thoracotomy to operate on the esophagus or for certain heart procedures.

Preparing for your surgery

  • Ask your doctor any questions you have about the procedure.

  • Have blood tests or other tests that your doctor suggests.

  • Ask your doctor about donating your own blood in advance of the procedure.

  • If you smoke, stop right away.

  • Tell your doctor about any medicines you're taking, including aspirin. Ask if you should stop taking them. Also mention any vitamins, herbs, or other supplements you take.

  • Don't eat or drink anything after midnight the night before your procedure, or as directed.

The surgery

  • The anesthesiologist can discuss the types of medicines you'll be given during the surgery and answer your questions. Once you're asleep, you're put in a comfortable position on your side and covered with sterile drapes.

  • The lung to be operated on is deflated. A breathing tube helps your other lung continue working. The surgeon can look at the deflated lung and do any needed surgery. In some cases, the surgeon may remove part or all of the lung and nearby lymph nodes.

  • Your surgeon makes an incision across your side. He or she separates your rib cage or removes a rib to reach your lungs.

  • When the procedure is finished, the surgeon puts one or more tubes in your chest temporarily. These are to drain fluid and air.

  • The surgeon then repairs the rib cage. He or she closes the muscle and skin with sutures or staples.

  • You will wake up in a recovery area, or sometimes in the intensive care unit. Your breathing tube is generally taken out before or just after you wake up.

Risks and possible complications

  • Risks of general anesthesia

  • Wound infection

  • Bleeding

  • Lung infection (pneumonia)

  • Air leak through the lung wall. This requires a longer hospital stay or another operation.

  • Worsening of any existing heart problems

  • Blockage of a blood vessel in the leg (deep vein thrombosis) with potential for blood clots in the lung (pulmonary embolism)

Updated:  

March 21, 2017

Sources:  

Resuscitative Thoracotomy: Technique. UpToDate.

Reviewed By:  

Fetterman, Anne, RN,Image reviewed by StayWell medical illustration team.,Mancini, Mary C, MD