What is keyhole surgery for lung cancer?

To remove lung tissue with less invasion than traditional open-thoracotomy surgery. Doctors often use VATS (video-assisted thoracoscopic surgery). VATS lung resections need two to four small incisions, most under an inch long. A multiportal tiny video camera goes through one cut, showing images on a video screen to guide the work. The other small incisions allow for operating surgical tools. In some cases, doctors use just one 3-5 cm incision for the camera and surgical tools. (uniportal VATS). Robotic-assisted thoracoscopic surgery is another keyhole surgery option that can be useful in certain cases. This method uses robotic arms, allowing the heart and chest surgeon to control the camera and tools inside the body using an external console. It can help in tricky situations, but it's much more expensive than regular keyhole surgery for lung cancer.

Why choose Keyhole Surgery?

• Less pain: Patients need fewer painkillers after their operation.
• Less scarring: One small cut, compared with a six- to ten-inch cut for open-chest surgery.
• Shorter hospital stay: Average time to go home after VATS is just over 3-5 days, compared with up to one week for open-chest surgery.
• Quicker recovery: Many people get back to their normal life in about a week, whereas 4-6 weeks of recovery are needed after open-chest surgery.

When is keyhole surgery suitable?

• Works best for early-stage lung cancer: Keyhole surgery has the most impact on patients who receive a diagnosis in the first stages.
• More widespread application: In the past, doctors didn't think it was a good fit for patients who had gone through chemo, radiation, or immunotherapy. These days, thanks to improved surgical expertise, doctors can perform even tricky procedures, including removing a whole lung (right or left).
• Helps with diagnosis: Doctors also use keyhole surgery to take samples of small or hard-to-reach lung spots when they can't do CT-guided biopsies.
• Wedge resection: This means cutting out a small section of the lung to find out if the spot is cancerous or not.
• Diagnostic lobectomy: When doctors suspect cancer, they might take out a whole lobe to diagnose it. Can perform lung surgery: - Wedge resection – removes a small part of the lung. - Segmentectomy – removes one segment of a lung. - Lobectomy – removes a whole lobe. - Pneumonectomy – removes the entire lung.

The Keyhole Surgery rocedure

• Keyhole lung surgery time changes based on each case and the exact operation. But removing a lung lobe for cancer lasts about 2 to 3 hours, sometimes much less. The cancer's size and the surgeon's skill play a big role in this.
• During the operation, the surgeon doesn't just remove the lobe with cancer. They also take out the lymph nodes linked to that lobe to check if cancer has spread there.

What is the recovery time for Keyhole Lung Surgery? Recovery from keyhole lung surgery varies. It depends on personal factors and the type of operation. Patients need just a few weeks.

Right After the Operation After surgery, patients will be in ICU for 1-2 days before moving them back to their ward.

• Doctors put in a chest tube connected to a drainage machine to remove extra air or fluid from around the lungs.
• Once patients are awake and feel okay, the staff often offers them a light food.
• To help with pain, doctors use a mix of modern pain control methods: - Local anaesthesia: Doctors inject a numbing medicine that lasts for a long time during the operation to cut down on pain later. - PCA pump: This device lets patients control their own pain relief. They can press a button to get small amounts of pain medicine (such as morphine/fentanyl). - Cryoanalgesia: In some cases, doctors freeze the nerves near the ribs to block pain signals and give relief that lasts longer.

Day 1-3 and the First Week

• In the first few days after surgery, you'll feel pain, discomfort, and have trouble breathing. Over time, these problems should get better. Most patients can do everyday tasks within a few weeks and go back to work in 4-6 weeks, but this can change from person to person.
• Keep in mind that everyone heals at their own pace. To recover well, you should follow your doctor's advice, attend all your check-ups, and do any rehab or physical therapy they suggest.
• Doctors prescribe pain medicines to keep patients comfortable; staying active is crucial too. More time in bed raises the risks of problems.

Week 2 to 3 months Post-surgery Patients who stick to the given advice should get back to their normal activities soon and regain their overall health and life as it was before surgery. When cancer cells show up in the lymph nodes, the cancer risk goes up, and your doctors might suggest more treatment like chemo or immunotherapy. Some patients also join cutting-edge clinical trials. It's common to have good and bad days during recovery, but on the whole, things tend to get better. Patients might also feel some pain as the day winds down.