definition, thoracotomy, video-assisted thoracoscopic surgery, lobectomy, lung transplant, pneumonectomy, wedge rection, pre-operative and post-operative nursing management.

1. LUNG SURGERY
PREPARED BY DOLISHA WARBI

2. DEFINITION:
Lung surgery is surgery done to repair or remove lung tissues.
COMMON SURGERIES INCLUDE:
qBiopsy of an unknown growth in or around the lung
qLobectomy, to remove one or more lobes of a lung
qLung transplant
qPneumonectomy, to remove a lung.
qSurgery to prevent the buildup or return of fluid to the chest (pleurodesis)
qSurgery to remove an infection in the chest cavity (empyema)
qSurgery to remove blood in the chest cavity, particularly after trauma
qSurgery to remove small balloon-like tissues (blebs) that cause lung collapse (pneumothorax)
qWedge resection, to remove part of a lobe in a lung

3. THORACOTOMY (open surgery):
• Patient have to lie on the table and arm placed above the head
• Surgeon will make a surgical cut between two ribs. The cut will go from the front of the chest wall to the back, passing
just underneath the armpit. These ribs will be separated or a rib may be removed.
• Lung on this side will be deflated so that air will not move in and out of it during surgery.
• Open lung surgery may take from 2 to 6 hours.
IT IS DONE TO:
• To diagnose an illness
• Patient who suffer from penetrating cardiac trauma
• Having cardiac tamponade.

4. VIDEO-ASSISTED THORACOSCOPIC SURGERY:
§ Several small surgical cuts is made over the chest wall.
§ A videoscope (a tube with a tiny camera on the end) and other small tools will be passed through these cuts.
§ Then, remove is done part or all of the lung, drain fluid or blood that has built up, or do other procedures.
§ One or more tubes will be placed into your chest to drain fluids that build up.
§ This procedure leads to much less pain and a faster recovery than open lung surgery.
IS DONE TO;
• Remove cancer
• Treat injuries
• Treat permanently collapsed lung tissue
• Remove lung tissue that is diseased or damaged
• Remove blood or blood clots (hemothorax)
• Remove tumors, such as solitary pulmonary nodule
• Remove infection in the chest cavity
• Remove fluid buildup in the chest cavity

5. LOBECTOMY:
A lobectomy is a surgery to remove one of the lobes of the lungs, the lungs section is called as lobes. The right lungs has
three lobes. The left lungs has two lobes.
Reasons for using lobectomy;
• Tuberculosis
• Lung abscess
• Emphysema
• Benign tumors
• Lung cancer
• Infection

6. PROCEDURE:
• A patient is ask to lie down on an operating table
• Antibiotic is given the procedure
• Anaesthesia is given throughout the procedure
• Patient in under ventilator
• A cut (incision) will be made on the front of the chest at the level of the lobes to be removed, the cut will go under the
arms around the back.

7. LUNG TRANSPLANT:
• A lung transplant is a surgical procedure to replace a diseases or a failing lungs with a healthy lungs.
• Depending on the medical conditions and long transplants may involve replacing one of the lungs or boot of them.
• Donor lungs can be retrieved from a living or a disease donor, a living donor can only donate one lobes with some
lungs diseases, a recipient may only need to receive a single lungs.

8. MOST COMMON ON REASONS FOR LUNG TRANSPLANTATION:
• 27% chronic obstructive pulmonary diseases COPD, including empysema.
• 16% idiopathic pulmonary fibrosis.
• 14% cystic fibrosis.
• 12% adopted formerly known as primary pulmonary hypertension.
• 5% alpha 1 antitrypsin deficiency
• 2% replacing previously transplanted lungs that have since failed.
• 24% other courses, including bronchiectasis and sarcoidosis.

9. PROCEDURE:
Ø An incision is made into the chest.
Ø Then the airway and blood supply to the lung is cut off .
Ø Then remove the diseases long and replace it with the healthy donors lung.
Ø Reattach the airway and blood vessel.
Ø Close up the incision.

10. PNEUMONECTOMY:
Pneumonectomy is defined as the surgical removal of the entire lungs.
This approach is sometimes recommended for non-small cell lung cancer treatment.

11. REASONS:
• Lung cancer
• Lung carcinoid tumors
• Certain lung injuries.
• Aspergillosis
• Bronchiectasis
• Tuberculosis
PROCEDURE:
• The patient may have to lie down on one side.
• General anaesthesia is given.
• Prepare the skin, then make an incision (cut) in the side and back, between two ribs.
• Separate the ribs to get to the lung. Also have to delicately cut or move tissue and structures around the lungs
• Deflate the lung and remove it through the incision.
Aspergillosis

12. WEDGE RESECTION:
A wedge resection involved the removal of lung cancer along with the wedge-shaped section of tissue surrounding the
tumor.
OR
Wedge resection is the surgical procedure to remove a triangle shape slice of tissues
These procedure remove less lung tissues than a lobectomy.

13. REASONS:
• Lungs mass or infection lesion.
• Congenital lobar
• Emphysema
• Small lung cancer.
PROCEDURE:
• The doctor might makes one to four incisions on one side.
• Then insert a thoracoscope (tube with a light and small camera) into the chest.
• The inserts specialized instruments through the incisions to remove tissue.
Congenital lobar

14. PRE-OPERATIVE NURSING MANAGEMENT:
Ø Monitor the vital sign mostly the respiration rate and the SPO2 level.
Ø Assess the patient condition.
Ø Administered antibiotic medication
Ø Educate the patient about the surgery procedure.
Ø Provide psychological support.
Ø Improve the ventilation and respiratory function
Ø Putting gown to the patient.
Ø Administered anaesthesia drugs for sedation
Ø Assist the patient during the procedure.
POST-OPERATIVE NURSING MANAGEMENT:
Ø Monitor the vital signs
Ø Monitor the airway pattern
Ø Administered the prescribed antibiotic and analgesic drugs.
Ø Suctioning if needed.
Ø Administered medication as prescribed by physician.
Ø Maintain the dietary pattern to the patient.
Ø Provide psychological support to the patient and family.
Ø Maintain dressing to the stoma area to prevent infection.
Ø Check the I/O every 3hr.