Catherine Spader, RN

What is a lobectomy?

A lobectomy, also called pulmonary lobectomy or lung lobectomy, is the surgical removal of a lobe of a lung. You have two lungs divided into sections called lobes. Your left lung has two lobes and your right lung has three lobes. Your doctor may recommend a lobectomy to treat lung cancer or a lung lesion, which is abnormal tissue. After a lobectomy, your remaining lung lobes continue to function.

A lobectomy most often refers to a lobectomy of the lung. In some cases, the term may refer to a lobectomy of other organs, such as the brain, thyroid, pancreas or liver. 

A lobectomy is a major surgery with serious risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having a lobectomy.

Other procedures that may be performed 

Your doctor may also remove nearby lymph nodes to examine them in the laboratory for cancer cells.

Types of lobectomy

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The types of lung lobectomy include:

  • Bilobectomy is the removal of two lobes.

  • Left upper lobectomy is the removal of the upper lobe of the left lung.

  • Left lower lobectomy is the removal of the lower lobe of the left lung.

  • Right upper lobectomy is the removal of the upper lobe of the right lung.

  • Right middle lobectomy is the removal of the middle lobe of the right lung.

  • Right lower lobectomy is the removal of the lower lobe of the right lung.

  • Sleeve lobectomy is the removal of a lobe and part of the air passage into the lung (bronchus). 

Why is a lobectomy performed? 

Your doctor may recommend a lobectomy to treat:

  • Bronchiectasis, which is scarring and widening of the airways in the lungs

  • Cancer that begins in the lung and is confined within one or two lobes

  • Congenital cystic adenomatoid malformation (CCAM), a noncancerous mass of abnormal lung tissue that is present at birth. Doctors generally recommend a lobectomy during infancy for this condition.

  • Fungal infections that are resistant to less invasive treatment

  • Lung blebs, which are large blisters in the lung that can cause it to collapse

  • Pulmonary sequestration, an abnormal type of lung tissue that develops before birth. This type of lung tissue does not function normally. Doctors generally recommend a lobectomy during infancy for this condition.

Who performs a lobectomy?

A thoracic surgeon performs a lobectomy. Thoracic surgeons specialize in the surgical care of the heart, lungs, trachea (windpipe), esophagus, diaphragm, and chest wall.

How is a lobectomy performed?

Your lobectomy will be performed in a hospital. Your surgeon will make an incision(s) between the ribs to remove the diseased lobe.  Your doctor will use one of the following approaches:

  • Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgery. Your surgeon will insert special instruments and a thoracoscope through three small incisions in your chest. The thoracoscope is a thin, lighted instrument with a small camera that transmits pictures of the inside of your body to a video screen. Your surgeon sees the inside of your chest on the video screen while performing surgery. Minimally invasive surgery generally involves a faster recovery and less pain than open surgery. This is because it causes less trauma to tissues. Your surgeon will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery. Some surgeons use a surgical robot assist in minimally invasive surgery.

  • Open surgery (thoracotomy) involves making a large incision in the chest between the ribs. Open surgery allows your surgeon to directly view and access the surgical area. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery. Open surgery requires a larger incision and more cutting and displacement of muscle and other tissues than minimally invasive surgery. Despite this, open surgery may be a safer or more effective method for certain patients.

It is possible that your surgeon may decide after beginning a minimally invasive procedure that you require an open surgery to safely and most effectively complete your surgery. 
Your surgeon may also decide after beginning a lobectomy that the entire lung needs removal. This is called a pneumonectomy. Your surgeon will staple off the lobe to be removed and tie any vessels that supply or drain blood to the lobe of the lung. After the specimen is removed, drains are placed to collect excess fluid from the lung and help to re-expand it. The incision(s) are closed with stitches or clips.  

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 lobectomy procedures and ask why your surgeon will use a particular type for you.