If you have early-stage lung cancer, you may want to talk to your doctor about minimally invasive thoracic surgery. If this option is right for you, it typically means less pain and a quicker recovery than with a standard operation.
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Thoracic surgeon Daniel Raymond, MD, says he’s able to use minimally invasive techniques around 80% to 90% of the time. When it’s right for the patient, it’s the best option, he says.
How does it work?
During minimally invasive thoracic surgery, a thin tube with a camera gives the surgeon a view into the chest without having to make a large incision or spread the ribs. They insert specialized tools through other small incisions to perform the operation. This can be accomplished by VATS (video-assisted thoracic surgery) or robotic surgery.
“We can treat most patients with early-stage lung cancers with video-assisted or robotic thoracic surgery,” Dr. Raymond says. “In fact, virtually every oncologic disease of the lung and esophagus — as well as benign disease of the chest — can often be treated with a minimally invasive approach.”
In the past, the only way to remove part of a lung (lobectomy) was with open chest surgery (thoracotomy). This option requires one large incision (6 to 8 inches) in the chest between the ribs, Dr. Raymond says.
Today, with better technology, thoracic surgeons often can use minimally invasive techniques. That usually means they’ll need only three, 1-inch incisions, he says.
What are the benefits?
In medical terms, you’ll get the same quality cancer operation but much less pain with minimally invasive thoracic surgery. What it means to you, says Dr. Raymond, is “fewer days in the hospital, less pain, less dependency on narcotic pain medication and a quicker return to normal activities.”
Furthermore, this approach leaves less scar tissue in your chest. If you need surgery later, the chances are better that a second minimally invasive procedure will work. There is additionally less disruption of normal chest wall function.
Another plus: If the surgeon runs into any safety issues, they can easily switch to open surgery.
Why isn’t minimally invasive surgery right for everyone?
In some cases, open chest surgery is better for you. That’s the case if you have a history of pulmonary infections or have had:
- Open chest surgery in the past.
- Radiation to the chest.
- Coronary artery bypass graft surgery.
Explore all options with your doctor and surgeon
In the near future, Dr. Raymond expects minimally invasive thoracic surgery to become “the gold standard for treating lung cancer.” More and better screening catches more lung cancers early, he says.
However, at this time, not all thoracic surgeons have the training or experience to use a minimally invasive approach. So it’s a good idea to talk to your doctors early about your goals and expectations.
Make sure your surgeon knows that you want to explore a minimally invasive option. Ask how frequently they perform the surgery. “You want to get a sense of their comfort level and experience,” Dr. Raymond says.
Ultimately, it may not work for you. But you’ll want to decide based on your medical condition and history. You don’t want a doctor’s preference or lack of training to limit your options, he says.
If the surgeon you’re working with lacks experience with minimally invasive approaches, it’s sometimes best to get another opinion or a new referral, Dr. Raymond says.
