Open Lung Surgery (Thoracotomy)

What is open lung surgery?

Open surgery of the lung is the older surgical method used in the treatment of thoracic surgical diseases. In open lung surgery, also called thoracotomy,, the rib cage of the patient is opened during surgery.

How is open lung surgery performed?

In open lung surgery, the chest cavity called the thorax is entered by opening between the ribs. With a 20-25 cm incision in this area, the muscles on the rib cage are cut initially. Afterwards, an instrument are placed, called retractor, betwwen ribs to open. Then, the necessary intervention is performed through this opening
The incision area may vary in open lung surgery. It can be under the breast, on the side or around the shoulder blade at the back.

In which diseases is open lung surgery performed?

Open lung surgery can be preferred for major operations on the lungs, esophagus, trachea and mediastinum. However, the most preferred method of surgery in thoracic surgery in the last 20 years is closed lung surgery. Due to the high experience and expertise required for closed lung surgery, in some centers even minor lung surgeries are still be performed as open lung surgery.

What are the advantages and disadvantages of open lung surgery?

 

As Professional surgical specialists, our biggest goal should be to intervene in a way that results with the minimal harm to the patient. Hence, if the patient and the conditions are suitable, our preference should be closed surgery of the lung with a smaller incision. However, in some rare cases, we may prefer open lung surgery method as well.

The main disadvantages of open lung surgery are as follows;

The risk of bleeding is high due to the large surgical area.

Patients may feel more pain in the postoperative period due to the size of the surgical area.
The patient may need to stay in the hospital for 6-7 days after surgery.
The risk of postoperative complications is higher. 

There is also a smaller and less invasive form of open lung surgery called ‘muscle-sparing thoracotomy’. After the operation, 1 or 2 tube-like chest tubes, also called ‘drains’, about the thickness of a finger, are inserted into the chest cavity and these drains may need to be left in place for a few days.