What is lobectomy?
A lobectomy is a surgical procedure to remove one lobe from your lung. You have five lung lobes—three on the right and two on the left. This surgery helps diagnose and treat lung conditions, including lung cancer, emphysema and infections.
Lobectomy is a standard procedure performed by thoracic surgeons who specialize in conditions in the chest. When cancer hasn’t spread too far in the lung, lobectomy helps preserve some of your healthy lung tissue instead of removing the entire lung.
Types of lobectomy
Depending on your specific condition and needs, there are different types of lobectomies. Your surgeon may use a traditional surgical approach, which uses a single large incision or a minimally invasive lobectomy, including video-assisted thoracic surgery (VATS) or robotic surgery. These procedures use several small incisions to remove your lung lobe.
Open lobectomy surgery
Video-assisted thoracic surgery (VATS)
Robot-assisted thoracoscopic surgery
Pneumonectomy vs. lobectomy
With a lobectomy, your surgeon only removes one of the five lobes that make up your two lungs. With pneumonectomy, your surgeon removes an entire lung.
When possible, lobectomy is the preferred treatment option because it preserves more of your lung tissue. However, the right procedure depends on the size, location and stage of your lung condition. For example, some lung tumors are large, have spread or are in the middle of the chest, so they can only be treated by removing the entire lung.
Why is a lung lobectomy performed?
Your care team may recommend a lobectomy when you have a lung condition that only affects one lobe. By removing the lobe, your surgeon can treat your symptoms and try to prevent the condition from spreading to other areas of the lung.
One of the most common reasons to have a lobectomy is for the treatment of lung cancer, but several other conditions can be treated with this surgery, too.
- Tuberculosis: Tuberculosis is a chronic infection in the lungs caused by bacteria. While it’s often treated with other options, like medications, a lobectomy is sometimes needed to remove a damaged area of the lung.
- Lung abscess: A lung infection may lead to fluid forming in the lung, which is called a lung abscess. If this condition can’t be treated with other options and becomes severe, you may need a lobectomy.
- Emphysema: Emphysema is a type of chronic obstructive pulmonary disease (COPD) that damages the lungs and makes it hard to breathe. While there isn’t a cure, a type of lung resection known as lung volume reduction surgery can help decrease symptoms in some people.
- Benign tumor: While benign tumors are not cancerous, they can still cause issues or symptoms as they grow in the lung. A lung lobectomy is sometimes recommended to remove the tumor and resolve these problems.
- Lung cancer: Especially in the early stages, lung cancer may be treated by only removing a lobe of the lung. Lobectomy is a standard treatment for non-small cell lung cancer.
- Fungal infection: In addition to bacterial infections in the lung, it’s also possible to develop a fungal lung infection. You may need a lobectomy to remove part of the lung that is damaged by this type of infection.
Preparing for lobectomy surgery
To get ready for a lobectomy and choose the procedure that is right for you, your doctor may order additional tests to check on your health, including blood and lung function tests. Before surgery, your care team will give you specific instructions about how to prepare in the weeks and days leading up to your lobectomy.
Some things to discuss with your care team include:
- Changing or stopping your medications before surgery, especially blood thinners.
- Getting help to quit smoking so that you qualify for surgery.
- Starting pulmonary rehabilitation to improve your lung health.
- Adding more exercise, such as walking, to your routine.
- Preparing your house for a smooth recovery and planning for a support person at the hospital and home.
What to expect during a lobectomy
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Before
Before
In the days leading up to your lobectomy, you may have other procedures to help check on your lungs and plan your surgery. For example, a pulmonary function test will give your care team more details about how well your lungs might work after surgery. If you have lung cancer, procedures like imaging tests and bronchoscopy help your team with lung cancer staging.
On the day of your surgery, you’ll meet with several members of your care team in the pre-op area, sign consent forms, ask questions and get an IV and monitors placed on your body. You may also be given antibiotics before your procedure.
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During
During
Once in the operating room, the exact steps of your surgery will depend on the type of lobectomy and your specific condition. For all types of lobectomies, your care team will place a temporary breathing tube and a urinary catheter while you are asleep.
At the end of your procedure, your surgeon will leave a chest tube in place to help drain fluid and air as you recover, and your incision—or incisions—will be closed up.
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After
After
After your lobectomy, you can expect to stay in the hospital for several days. Most of the time, you will be in a regular hospital room after the recovery area, but sometimes, a short stay in the intensive care unit is needed for a lung lobectomy.
In the hospital, your care team will help you manage your pain. You’ll be encouraged to get up and start moving within a day of your procedure. You may also see a respiratory therapist and do routine breathing exercises to reduce the chances of pneumonia. The chest tube or tubes that were placed during surgery will be removed before you leave the hospital.
At home, continue breathing exercises and follow your team’s instructions about activities, medications and incision care. It may take several weeks or months to feel back to normal after a lobectomy.
Before
In the days leading up to your lobectomy, you may have other procedures to help check on your lungs and plan your surgery. For example, a pulmonary function test will give your care team more details about how well your lungs might work after surgery. If you have lung cancer, procedures like imaging tests and bronchoscopy help your team with lung cancer staging.
On the day of your surgery, you’ll meet with several members of your care team in the pre-op area, sign consent forms, ask questions and get an IV and monitors placed on your body. You may also be given antibiotics before your procedure.
During
Once in the operating room, the exact steps of your surgery will depend on the type of lobectomy and your specific condition. For all types of lobectomies, your care team will place a temporary breathing tube and a urinary catheter while you are asleep.
At the end of your procedure, your surgeon will leave a chest tube in place to help drain fluid and air as you recover, and your incision—or incisions—will be closed up.
After
After your lobectomy, you can expect to stay in the hospital for several days. Most of the time, you will be in a regular hospital room after the recovery area, but sometimes, a short stay in the intensive care unit is needed for a lung lobectomy.
In the hospital, your care team will help you manage your pain. You’ll be encouraged to get up and start moving within a day of your procedure. You may also see a respiratory therapist and do routine breathing exercises to reduce the chances of pneumonia. The chest tube or tubes that were placed during surgery will be removed before you leave the hospital.
At home, continue breathing exercises and follow your team’s instructions about activities, medications and incision care. It may take several weeks or months to feel back to normal after a lobectomy.
Risks and complications of a lung lobectomy
As with all types of lung surgery, a lung lobectomy has risks. The exact risks will depend on a few factors, such as whether you have an open or minimally invasive procedure and your overall health before surgery.
It’s important to talk with your doctor about the benefits, risks and goals of your lobectomy so that you can feel confident in your path forward.
Some risks of lobectomy include:
- Side effects of anesthesia
- Infection around the incision or a chest infection, like pneumonia
- Lung collapse or pneumothorax
- Excess fluid buildup around the lungs, called pleural effusion
- Irregular heartbeats, including atrial fibrillation
- Excessive bleeding
- Blood clots
- Buildup of pus in the chest cavity
- Ongoing pain after surgery, called post-thoracotomy syndrome
Frequently asked questions
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What fills the space after a lobectomy?
After a lobectomy, the remaining healthy lung tissue often moves or adjusts to fill in for the missing lobe. A new lung lobe doesn’t grow back.
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How long does lobectomy take?
Open lobectomy surgery can take two to six hours to perform. If you have a minimally invasive approach to lobectomy, such as video-assisted or robotic-assisted thoracoscopic surgery, expect your procedure to take one to three hours.
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Do lungs regenerate after lobectomy?
No. A lobe can’t regrow in the lung after it is removed. However, other areas of your lung or the diaphragm may shift or adjust to fill in some of the space taken up by the lobe.
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Does lung cancer come back after a lobectomy?
While lung cancer can come back after a lobectomy, many people are cancer-free at five years. One study found that cancer had not returned in about 64% of people who had a lobectomy for early-stage non-small cell lung cancer.
Lung cancer may return after the procedure if all the cancer cells weren’t removed during surgery or if there were cancer cells that had already started to spread to other areas of the body that were too small to be detected.
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How painful is a lobectomy?
Most people have pain, soreness, achiness or stiffness in the chest after a lobectomy. These symptoms are most common in the first six weeks, but some discomfort or stiffness can last a few months. Your experience also depends on the type of lobectomy you have.