Lung Cancer Surgery

Dr. Nwogu is part of a team of surgeons using robotics to improve quality of life for thoracic surgery patients.

Surgery for lung cancer removes the tissue that contains the tumor. The surgeon also removes nearby lymph nodes. 

Surgical approaches to lung cancer at Roswell Park include the following:

  • Thoracoscopic Lobectomy: The surgeon removes a lobe of the lung. This is the most common surgery for lung cancer.
  • Thoracoscopic Pneumonectomy: The surgeon removes the entire lung.
  • Wedge Resection: The surgeon removes the tumor and a small part of the lung.
  • Sleeve Lobectomy: The surgeon removes a lung tumor in a lobe of the lung and a part of the main bronchus (airway). The ends of the bronchus are rejoined and any remaining lobes are reattached to the bronchus. This surgery is done to save part of the lung. This surgery is also called sleeve resection.

World Leader in Minimally Invasive Surgery

"If you perform a big open surgery on [a patient], your ability to get them through the operation is hampered. But minimally invasively, you can give them multimodality therapy and the logical conclusion is that there will be better outcomes."
Sai Yendamuri, MD, FACS

Video-assisted thoracic surgery (VATS) offers a minimally invasive surgical alternative with many benefits for the patient. Nationally, only 20-30 percent of lung surgeries use the VATS approach, but at Roswell Park, the rate of using VATS is as high as 90 percent. Roswell Park is the world leader in the number of VATS procedures for removal of a lung. The entire surgical team incorporates minimally invasive techniques into lung cancer treatment.

How VATS Works

Our surgeons make three small incisions, or ports. A scope equipped with a camera is inserted through one port, providing an interior view of the chest, while surgical instruments are inserted through the other ports. Because the smaller incisions heal faster than large, traditional incisions, patients undergoing VATS typically enjoy these benefits:

  • Shorter hospital stay: Duration is typically three to four days. Fewer patients need nursing services or home health care afterward.
  • Faster return to normal activities: Patients have no lifting restrictions and may go back to work very quickly. Patients are nearly normal in three to four weeks.
  • Significantly less pain: Many patients don’t require any pain medication following surgery.
  • A safer surgical option: Some people, especially older patients, those who are frail and those with other health problems, would not be eligible for traditional surgery.

Previously, VATS was not performed in patients with scar tissue in the chest due to asbestos exposure, prior radiation or chemotherapy. By improving on existing technology, Roswell Park lung surgeons are finding their way around that, too.

How Robotic Surgery Works

Robot-assisted thoracic procedures are performed using the da Vinci® Surgical System. Instead of standing and operating over the patient, the surgeon sits at a special station and sees a 3-dimensional (3-D) view of the surgery. This special camera magnifies the image 10 times larger than normal. The tools of the robot are very small, but are more flexible and more mobile than the surgeon’s fingers. This allows surgeons to complete complex surgeries using smaller incisions in more confined regions of the body.

Advantages of Robot-Assisted Thoracic Surgery

  • Decreased blood loss after surgery
  • Decreased risk of blood transfusion
  • Shortened hospital length of stay
  • Decreased post-operative pain
  • Less scarring
  • Shorter recovery time

Pancoast Tumor Surgery

A superior sulcus tumor, also commonly referred to as a Pancoast tumor, is a rare form of lung cancer that arises in the upper portion of either the right or the left lung and interferes with the surrounding structures — the ribs, the lining of the chest cavity, the spine, nerves and blood vessels.

Surgery for Pancoast tumors involves resecting the upper lobe of the lung as well as any portion of the chest wall, or other structures that are involved with the tumor. 

At Roswell Park, patients have access to the latest advancements in Pancoast tumor surgery. Some of the benefits include:

  • A high-volume thoracic surgery center with expertise in the complex surgical management of these tumors.
  • A multidisciplinary approach to treatment involving medical, radiation and thoracic surgical oncologists.
  • Close monitoring during all phases of treatment, surgery and recovery.
  • Surgeons from multiple specialties who routinely perform Pancoast tumor surgery.
  • The option for a minimally invasive approach for some surgical resections.