Lungs

Bullae Resection

Blebs or bullae are thin walled balloon-like extensions or air sacs. They are also called pulmonary cysts. These cysts, blebs or bullae are sacs in the lung tissue that are filled with air or gas. They can be detected by radiological tests, such as an X-ray or a CT scan.Surgery to remove all or part of an involved lung involves making a several small incisions on the chest wall (thorax). This permits placement of a camera and instruments to remove the affected lung segment.

Exploratory Thoracotomy

Exploratory thoracotomies are performed to gain better insight of organs in the chest after a thoracic trauma. Thoracic trauma may be serious and a cause of significant disability and mortality. This is the leading cause of death after head and spinal cord injury. Blunt thoracic injuries are the primary or a contributing cause of about a quarter of all trauma-related deaths. The mortality rate is about 10%. Classified as either blunt or penetrating injuries, they have different pathophysiologies and clinical courses.

Specific types of chest trauma include:

  • Injuries to the chest wall
  • Chest wall contusions or hematomas
  • Rib fractures
  • Flail chest
  • Sternal fractures
  • Fractures of the shoulder girdle
  • Pulmonary injury (injury to the lung) and injuries involving the pleural space
  • Pulmonary contusion
  • Pulmonary laceration
  • Pneumothorax
  • Hemothorax
  • Hemopneumothorax
  • Injury to the airways
  • Tracheobronchial tear
  • Cardiac injury
  • Pericardial tamponade
  • Myocardial contusion
  • Blood vessel injuries
  • Traumatic aortic rupture, thoracic aorta injury, aortic dissection

This also applies to injuries to other structures within the torso:

  • Esophageal injury (Boerhaave syndrome)
  • Diaphragm injury

Lobectomy

Removal of just one lobe of the lung is specifically referred to as a lobectomy. A lobectomy of the lung is performed in early stage non-small cell lung cancer patients. It is not performed on patients that have lung cancer that has spread to other parts of the body. Tumor size, type, and location are major factors as to whether a lobectomy is performed.

Lung Biopsy

This is a procedure for obtaining a small sample of lung tissue for examination. The tissue is usually examined under a microscope (by a pathologist) and sent to the microbiological laboratory for culture. A lung biopsy is usually performed to determine the cause of abnormalities, such as nodules that appear on chest x rays. It can confirm a diagnosis of cancer, especially if malignant cells are detected in the patient's sputum or bronchial washing. In addition to evaluating lung tumors and their associated symptoms, lung biopsies may be used to diagnose lung infections, especially tuberculosis and pneumocystis pneumonia, drug reactions, and chronic diseases of the lungs such as sarcoidosis and pulmonary fibrosis. A lung biopsy can be used for treatment as well as diagnosis.

Lung Resection

A lung resection is a surgical procedure in which all or part of a lung is removed by a thoracic surgeon (a specialist who has received detailed training in surgery involving the thoracic cavity). It is major surgery and often requires a hospital stay for several days. Historically, lung resections involved a large incision (thoracotomy) between the ribs to access the chest cavity. Presently, in the majority of situations several small incisions are created to permit placement of small instruments within the chest cavity. this is often referred to as minimally invasive surgery. These procedures are preferred as they are less uncomfortable for the patient and often significantly reduce the post-operative recovery period.

Lung Volume Reduction Surgery (LVRS)

Lung Volume Reduction Surgery, or LVRS, can improve the quality of life for certain COPD and emphysema patients. Parts of the lung that are particularly damaged by emphysema are removed, allowing the remaining, relatively good lung to expand and work more efficiently.. Conventional LVRS involves resection of the most severely affected areas of emphysematous, non-bullous lung (aim is for 20-30%). This surgical option involves a mini-thoracotomy for patients suffering end stage COPD due to underlying emphysema, and can improve lung elastic recoil as well as diaphragmatic function.

Lung Wedge Resection

Lung resections are commonly performed to remove diseased areas of the lung. In a procedure known as a wedge resection, a small portion of lung involving the area of suspicion is removed. In a lobectomy procedure, an entire lobe of the lung is removed. Lung resections can also be done to address congenital abnormalities and other problems related to the lungs, such as an abscess.

Pneumonectomy

A Pneumonectomy is a surgical procedure to remove the entire lung on a particular side of the chest. This is compared to a lobectomy that removes a only a portion of the lung referred to a a lobe. A pneumonectomy most commonly treats non-small cell lung cancer, when a less invasive procedure, such as a lobectomy, cannot remove the entire tumor. This may occur if the tumor is large, if it has spread beyond a single lobe, or if it is located in the central area of the lungs.

Thoracotomy

A Thoracotomy is an incision into the pleural space of the chest. It is performed by surgeons to gain access to the thoracic organs, most commonly the heart, the lungs, or the esophagus, or for access to the thoracic aorta or the anterior spine (the latter may be necessary to access tumors in the spine).