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Minimally Invasive Surgery for Lung Cancer: It Seems Like the Stuff of Science Fiction

Abington Health Thoracic Surgeon Removed Portions of the Lung Through Tiny Holes in the Chest

Sara Humphreys

Sara Humphreys

Last spring when Sara Humphreys was diagnosed with lung cancer, she had no symptoms of the disease. Most people don’t. In fact, signs and symptoms generally don’t appear until the cancer is more advanced and more difficult to treat. Sara is living testimony to the fact that early detection, when the disease is most treatable, saves lives.

Doctors were watching an abnormality found in Sara’s right lung several years earlier. During her most recent routine follow-up, Pulmonologist Richard Snyder, MD, medical director, Critical Care, detected a change on her x-ray. He referred Sara to Cardiothoracic Surgeon Colleen Gaughan, MD, who is fellowship-trained in cardiothoracic surgery, with advanced training in minimally invasive thoracic surgery.

Fortunately, Sara’s lung cancer was detected early, so it had not spread outside the lungs. Only about 25 percent of all lung cancers are detected at such an early stage that surgery can be considered for primary treatment. After a comprehensive evaluation, Dr. Gaughan recommended a lobectomy – surgical removal of one of five lobes of the lung. It is one of the most commonly performed procedures to treat lung cancer. Dr. Gaughan determined Sara would be a good candidate for minimally invasive lobectomy.

At 75, Sara was frightened and worried about undergoing major lung surgery at her age. She was concerned about her quality of life. After considering her options, the Wyndmoor resident decided to pursue the minimally invasive surgery, also known as video-assisted thoracic surgery (VATS).

The minimally invasive procedure offers several advantages for eligible patients over traditional thoracotomy:

  • less postoperative pain and inflammation
  • a shorter hospital stay
  • shorter duration of use of drains
  • preservation of lung function, and
  • a faster return to normal activities.

A quicker recovery also benefits patients who must begin chemotherapy treatment as soon as possible after surgery. Traditional thoracotomy may be a preferred treatment for some patients with large tumors, lymph node involvement, or prior chest surgery.

However, since Sara was fortunate to have her cancer detected so early, her treatment plan was surgery alone. During the procedure, Dr. Gaughan made three incisions in Sara’s chest. Guided by a tiny video camera and other specialized instruments inserted in the incisions, Dr. Gaughan removed the middle lobe of Sara’s right lung through one of the incisions. Her largest incision measured only two to three inches.

Sara spent just three days in the hospital and was discharged home, where she has been recovering well ever since. “My surgery and recovery went so smoothly, it’s almost unbelievable,” she said. “Hearing the diagnosis of lung cancer was scary. They took such good care of me at Abington, the fear didn’t last long. I knew I was in good hands.”

Sara’s successful surgical outcome supports the findings of a major new study using data from the National Cancer Data Base, which evaluated over 100,000 patients who underwent major lung resection. It shows that major lung surgery is safer than ever, especially at hospitals that are not considered low volume, like Abington Memorial Hospital. Christopher M. Pezzi, MD, AMH’s director of Surgical Oncology, presented this study at the national meeting of the American Association for Thoracic Surgery in April.

In addition to VATS, Dr. Gaughan also performs minimally invasive robotic thoracic surgeries using sophisticated instrumentation to operate through several small incisions in the chest, with no need to spread the ribs to remove the affected portion of the lung. In comparison, during a traditional open thoracotomy, the surgeon makes a 10- to 12-cm. incision in the chest and uses a retractor to spread the ribs open to access the lungs.

“Abington Memorial Hospital provides the refined instrumentation, as well as the surgical expertise essential to successful surgical lung cancer treatment,” said Dr. Gaughan.

Sara and husband Charles have launched the next phase of their lives with a recent move to a new home. A retired floral designer and lecturer, and floral design judge emeritus, Sara still works with flowers, although “retirement is primarily about our four grandchildren,” she beamed. No doubt, they too, will benefit from an occasional grandmotherly lecture, and continue to grow and bloom under their grandmother’s tender care.

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