What Is Thoracoscopic Wedge Resection?
Thoracoscopic wedge resection is a minimally invasive surgical procedure that involves a small surgical cut (incision) for the removal of a small, wedge-shaped piece of the lung tissue. This surgery is used for removing a small tumor or to diagnose lung conditions.
In this surgery, a thin flexible tube-like device, called a thoracoscope, is inserted through a small incision in the patient’s chest. The thoracoscope carries a tiny camera that helps the surgeon to visualize the inside of the chest and operate without performing a big incision or spreading the ribs. The wedge can be sent for lab examination to diagnose the disease condition. The procedure is also called video-assisted thoracoscopic surgery (VATS).
Certain medical conditions, such as lung cancers, may require a part of the lungs to be removed to limit the spread of cancer in the body. The lungs are divided into segments based upon certain anatomical criteria such as different blood supply.
In lung segmentectomy surgery, these anatomic criteria are considered to resect or remove a lung segment. In wedge resection, however, nonanatomic lung resection is performed to remove a wedge of the lungs. Removing a small diseased portion of the lungs is a great approach because it preserves most of the functional lungs. This is only possible when the disease is confined to a small part of the lungs.
Thoracoscopic wedge resection is an ideal procedure for the treatment of lung cancers that require the removal of small lesions of cancer cells (lung nodules). The procedure is not advised if the tumor cells are not embedded deep within the lung tissue.
A thoracoscopic wedge resection surgery is also preferred for patients who cannot tolerate a major surgery or for removing a large-sized section of the lungs, such as a lobe (lobectomy), when there may be a significant decrease in lung function. The procedure is used for both the diagnosis and treatment of many cancers and noncancer lung conditions.
Is thoracoscopic wedge resection safe?
Thoracoscopic wedge resection involves a small incision and is safer than conventional open surgery. The procedure is relatively safe even in high-risk patients such as elderly individuals and those with long-term heart or lung conditions. The procedure removes a minimal lung tissue resulting in earlier recovery and fewer postoperative complications than conventional procedures on the lungs.
How long does thoracoscopic wedge resection take?
The duration of the thoracoscopic wedge resection surgery depends on many factors such as the extent or severity of the disease and the location of the diseased part of the lung (lesion) to be removed. The surgery can usually take three to four hours, but the patient may ask the doctor about the duration of their surgery because the doctor can guide them more accurately.
What are the complications of thoracoscopic wedge resection?
Although a thoracoscopic wedge resection surgery is a safe and reliable procedure, particularly useful for lesions at the lung periphery or small lesions at the outer one-third of the lung, it may have some complications:
- Pain
- Bleeding
- Infections
- Injury to the muscles, nerves, or blood vessels
- Delayed or nonhealing wound
- Wound dehiscence (a condition in which the wound gives way or opens up)
- Hoarseness of voice due to anesthesia
- Arrhythmias (irregular or abnormal heart rhythm)
- Angina (chest pain due to decreased blood supply to the heart)
- Hemothorax (bleeding inside the chest)
- Persistent air leak
- Subcutaneous emphysema (entrapment of air under the skin)
- Pneumonia
- Scarring of lungs
- Bronchopleural fistula (abnormal communication between the large airways in the lungs, called the bronchi, and space between the membranes that line the lungs, called the pleural cavity)
- Local and thoracoscope port-site recurrence of cancer
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