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Newer techniques allow surgeons to use a smaller incision (four to six inches) in some cases. This type of procedure is sometimes called a muscle-sparing thoracotomy because the surgeon does not cut through your chest muscles. Instead, the surgeon moves the muscles out of the way or separates the muscle fibers. This is not a minimally invasive procedure, but it may provide similar advantages. This includes faster recovery times and less pain.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital based on your diagnosis, age, medical history, general health, and possibly your personal preference. Learn about the different thoracotomy procedures and ask why your surgeon will use a particular type for you.

Types of anesthesia that may be used

Your surgeon will perform a thoracotomy using general anesthesia. General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and will not feel any pain. 

You may also have a peripheral nerve block infusion in addition to general anesthesia. A peripheral nerve block infusion is an injection or continuous drip of liquid anesthetic. The anesthetic flows through a tiny tube inserted near your surgical site to control pain during and after surgery.

What to expect the day of your thoracotomy

The day of your surgery, you can generally expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.
  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. Your care team will give you blankets for modesty and warmth.
  • Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will receive.
  • A surgical team member will start an IV.
  • A tube will be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgery as they happen. 
  • The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and your recovery until you are alert, breathing effectively, and your vital signs are stable.

What are the risks and potential complications of a thoracotomy?  

As with all surgeries, a thoracotomy involves risks and possible complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

  • Anesthesia reaction, such as an allergic reaction and problems with breathing 
  • Bleeding, which can lead to shock
  • Blood clot, in particular a deep vein thrombosis that develops in the leg or pelvis. A blood clot can travel to your lungs, heart or brain and cause a pulmonary embolism, heart attack, or stroke.
  • Infection and septicemia, which is the spread of a local infection to the blood. This includes pneumonia.

Potential complications of a thoracotomy

Complications of a thoracotomy include:

  • Air or gases trapped in your chest
  • Damage to your lungs, heart, or blood vessels
  • Numbness or sensitivity of the chest skin
  • Persistent pain
  • Recurrent fluid buildup

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery
  • Informing your doctor if you are nursing or if there is any possibility of pregnancy
  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage 
  • Taking your medications exactly as directed
  • Telling all members of your care team if you have any allergies 

How do I prepare for my thoracotomy? 

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome.