Keyhole lung surgery typically takes between one and two hours of actual operating time, depending on the complexity of the procedure. A smaller operation like removing a wedge of tissue averages about an hour, while removing an entire lobe of the lung takes closer to two hours. But the total time you’ll spend in the operating room is longer than the surgery itself, once you factor in anesthesia and preparation.
Operating Time by Procedure Type
Not all keyhole lung surgeries are the same, and the type of procedure is the biggest factor in how long the operation lasts. The two most common are wedge resections, where a small section of lung tissue is removed, and lobectomies, where an entire lobe is taken out.
A wedge resection is the shorter of the two. Studies report an average operating time of about 58 minutes, with most falling in the range of 50 to 85 minutes. More complex cases, particularly those requiring additional steps like fluoroscopy guidance to locate small nodules, can push closer to 105 minutes.
A lobectomy is a bigger operation. The median time for a keyhole lobectomy is about two hours, according to Cleveland Clinic. This can vary based on the location of the lobe being removed, whether lymph nodes need to be sampled, and how much scar tissue or inflammation is present from prior infections or treatments.
Total Time in the Operating Room
The surgical clock only starts when the surgeon makes the first incision. Before that, there’s a significant block of time devoted to anesthesia and positioning that adds to your total experience in the operating room.
General anesthesia for thoracic surgery involves placing a specialized breathing tube that allows the surgeon to deflate one lung while the other keeps working. This setup, formally called “anesthesia ready time,” has a median duration of about 51 minutes across surgical specialties, with most patients falling in a 38 to 66 minute window. After that, the surgical team positions you on your side, cleans and drapes the surgical area, which adds roughly another 36 minutes.
So for a two-hour lobectomy, you can realistically expect to be in the operating room for about three and a half to four hours total. For a shorter wedge resection, the total room time is closer to two and a half to three hours. This doesn’t include time spent in the pre-operative holding area beforehand or the recovery room afterward.
Robotic vs. Traditional Keyhole Surgery
Some hospitals now offer robotic-assisted versions of keyhole lung surgery, where the surgeon controls robotic arms through a console rather than holding the instruments directly. Both approaches use the same small incisions, but the robotic version tends to be slightly faster.
In a study comparing the two techniques for segmental lung resections, robotic surgery averaged about 59 minutes compared to 66 minutes for traditional keyhole surgery. The robotic group also had less blood loss during the operation and fewer postoperative complications. The difference in operating time is modest, around seven minutes, but it reflects the greater precision and range of motion the robotic instruments provide.
How Keyhole Compares to Open Surgery
If you’re weighing keyhole surgery against a traditional open approach (thoracotomy), the operating times are often similar. The real advantage of keyhole surgery shows up in recovery. Patients who have keyhole lobectomies spend an average of four days in the hospital, compared to five and a half days for those who have open surgery. The smaller incisions also mean less pain during recovery, fewer wound complications, and a faster return to normal breathing capacity.
What Recovery Looks Like
After surgery, you’ll spend time in a recovery room while the anesthesia wears off. Most patients have a chest drain in place to remove any fluid or air that collects around the lung, and how quickly that drain comes out is one of the main factors determining when you go home.
For a wedge resection, hospital stays can be as short as one to two days if the drain output is minimal and the lung re-expands well. Some centers now perform smaller keyhole procedures as day surgery, discharging patients the same day. For a lobectomy, the typical hospital stay is around four days, though this varies depending on how your remaining lung tissue adapts and whether any air leaks persist at the drain site.
Once home, most people need several weeks before they feel ready for full activity. Light walking is encouraged from the first day after surgery, and most people can handle daily tasks like cooking and light housework within two to three weeks. Returning to physically demanding work or exercise generally takes four to six weeks after a keyhole procedure, roughly half the recovery timeline of open surgery.