Lung surgery, also known as thoracic surgery, involves procedures on the lungs, chest wall, and surrounding structures, and its duration is highly variable. The time required for a lung operation depends on the specific surgical goal and the patient’s individual circumstances. The total time a person spends under anesthesia and in the operating room suite is a sequence of distinct phases, with the actual removal or repair of tissue being only one part of the overall process.
How Procedure Type Affects Duration
The most significant factor determining the length of lung surgery is the extent of lung tissue that needs to be removed. Simpler, tissue-sparing procedures are shorter than those involving the removal of an entire section of the lung. A wedge resection or segmentectomy, which removes only a small piece of the lung, can often be completed in one to two hours, depending on the presence of scar tissue.
An intermediate and more common procedure is a lobectomy, which involves removing an entire lobe of the lung, typically taking a couple of hours for the surgical portion. This procedure requires more complex anatomical dissections than a wedge resection, which adds to the operating time. The most extensive operation is a pneumonectomy, the removal of an entire lung, which often takes the longest, sometimes requiring four to five hours of surgical time.
The surgical approach also affects the duration, with minimally invasive techniques being faster or comparable to open surgery for similar procedures. Video-Assisted Thoracoscopic Surgery (VATS) or robotic surgery uses small incisions and specialized cameras. While these approaches often lead to faster recovery, a robotic lobectomy averages around 214 minutes, reflecting the setup time for the specialized equipment, compared to 178 minutes for an open thoracotomy.
Breaking Down the Operating Room Timeline
The total time spent in the operating room (OR) begins well before the surgeon makes the first incision and continues after the surgical site is closed. The pre-incision phase involves patient positioning, often on the side for lung surgery, and the administration of general anesthesia. This preparation includes placing monitoring lines, such as arterial lines for continuous blood pressure monitoring, and intubating the patient to connect them to a ventilator.
This initial setup period, which ensures the patient is stable and the surgical field is prepared, can take around an hour before the surgical phase begins. The surgical phase is the time from the incision until the final closure of the wound. During this phase, the actual resection and repair occur, followed by the placement of one or more chest tubes to drain fluid and air.
Once surgical closure is complete, the post-surgical phase begins, focusing on safely waking the patient from general anesthesia. The breathing tube is typically removed (extubated) in the operating room or immediately upon transfer to the recovery area. The patient is then stabilized, and monitors are checked before being transported out of the OR suite.
Immediate Post-Surgical Recovery Time
After leaving the operating room, the patient is immediately taken to the Post-Anesthesia Care Unit (PACU). This phase is dedicated to close monitoring while the immediate effects of anesthesia wear off. Nurses in the PACU track the patient’s temperature, heart rate, blood pressure, and oxygen saturation levels.
The recovery team manages initial post-operative pain, often using patient-controlled analgesia (PCA) or epidural pain medicine. The primary goal is to ensure the patient is breathing effectively and that their vital signs are stable before moving to a less monitored hospital setting. Patients may stay in the PACU for a few hours, or sometimes overnight, depending on their stability.
Unforeseen Elements That Extend Surgery
Even with precise planning, various factors can lead to unexpected additions to the estimated surgical time. Patient comorbidities, such as pre-existing heart or chronic lung conditions, require the anesthesia team to proceed more slowly. Patients with reduced pulmonary function may require extra time for positioning and for the anesthetic management of their single working lung during the procedure.
Unexpected findings encountered once the surgery is underway can cause significant delays. The discovery of dense scar tissue or adhesions from previous infections or procedures can complicate the dissection and removal of the lung tissue. If the tumor is greater than anticipated, requiring a more extensive resection or an unplanned conversion from a minimally invasive approach to an open thoracotomy, the surgical time will increase substantially. Anesthesia management issues, such as difficulty maintaining stable blood pressure or oxygenation, may require the surgical team to pause the procedure until the patient’s condition is optimized.