Pneumonectomy is a surgical procedure to remove the entire lung in one side of the chest. It is performed treat patients with lung cancer. At times, it is used to treat benign disease of the lung.
We use the most advanced robotic system called Da Vinci Xi to perform the pneumonectomy. The name of the procedure is “Robot-assisted thoracoscopic pneumonectomy.” We perform the procedure through small incisions in the chest. We identify, mobilize and divide the blood vessel going into and out of the lung and the airway attached to the lung using a stapler. A chest tube is placed in the area at the end of the case to remove any air or fluid.
Overall, the risks of the operation are very low. Risks may include pneumonia and atrial fibrillation. With any operation, there is a risk of injuring any structure that we operate around including the phrenic nerve, major vessels, pericardium and diaphragm. Other risks may include bleeding and infection at the site of surgery. There is always a risk of needing to convert from a small incision to a larger incision to safely complete the operation.
Hospital Stay: 4 to 5 Days
After the operation, the patient is admitted to the Intensive Care Unit (ICU) typically for 1 day. Once the patient recovers, he or she is transferred to the surgical floor. On average, patients are in the hospital for four to five nights. Patients start a regular diet during the night of the surgery along with pre-emptive pain control with around the clock pain medication. Every day, the chest tube is evaluated to determine if the tube can be safely removed. Once the patient’s chest tube is removed with good pain control, they are ready to continue the recovery at home.
We advise our patients to stay ahead of the pain with pre-emptive pain control. Instead of taking pain medication after having pain, we ask patients to take pain medication in regular intervals. The typical regimen for post-operative pain medication is:
3 days of Aleve (Naprosyn) 1 tab two times a day
5 days of Tylenol (Acetaminophen) 1 g three times a day
7 days of Neurontin (Gabapentin) 300 mg three times a day.
After 7 days, take Tylenol as needed. If this regimen is not adequate to control pain, we ask patients to call our office.
In order to further help with recovery from surgery, we advise patients to walk at least three times a day, work on the incentive spirometer, and sit in a chair for at least 6 hours a day for about a week after the surgery. We advise patients to avoid heavy lifting for 6 weeks. As long as the patient is not on narcotic pain medication, it is safe to drive.