This is a surgical procedure aimed at removing part of the organ or gland. It differs from resection in that it is performed exclusively within the anatomical boundaries.
It is often prescribed to stop the spread of malignant cells through the organ. The procedure is performed under general anesthesia.
What kind of diseases is carried out?
The operation is assigned to the lungs, the brain, the thyroid and the liver. Indications:
- cancer,
- birth defects,
- tuberculosis,
- abscesses,
- emphysema,
- benign formations that impede organ function,
- recurrence of cystic formation.
With epilepsy, when other treatment does not help, lobectomy is prescribed.
Types of Thorascopic Resection
Such manipulations are performed using endoscopic instruments. The surgical intervention is divided into several types:
- Atypical resection. It is used in the treatment of benign formations. With the use of a small tool, the tumor is removed and the wound is stapled. The removed parts are output through the slits.
- Lobectomy. Assigned to cancer or multiple benign formations. This kind of manipulation allows you to remove lymph nodes, carry out the elimination of spontaneous pneumothorax.
- Thorascopic operations with resection. Applied in the presence of formations that do not affect the trachea and bronchi. The advantage of this type is the lack of the need to make large incisions. Therefore, the postoperative period is more favorable.
Preparing for operation
The patient is assigned a blood and urine test, consulted by an anesthesiologist and surgeon. X-rays, CT, spirography and other methods are performed.
If the operation is done on the lungs, then samples are given. With their help, it is determined how much tissue will be sufficient for the functioning of the respiratory system.
Course of operation
Lobectomy of the lung
Carried out for tumors, inflammatory processes, infectious and parasitic diseases, bronchiectasias, adhesions, focal lungs parenchyma.
The operation is performed with intubation of the trachea. If there is evidence, intubation of the bronchi, the main bronchus on the side of the lesion, may be prescribed.
Upper right
The patient is placed on the left side. The first trocar is set in the 7 intercostal space. The incisions are made in 4-5 intercostal spaces along the posterior muscular line. The lung is pulled backward, the diaphragm nerve is placed on the holder.
Then there is ligation of the pulmonary veins, the ligation and the intersection of the anterior trunk of the artery are performed. Inter-branch spikes between the upper and middle lobes are divided.
After ligation and intersection of A3, A1-A2, the bronchus of the upper lobe of the lung is taken to the holder. The procedure ends with a suture.
This video shows an open upper lobectomy of the lung on the right with mediastinal lymph dissection:
Average
Similar to the previous species. Ligation and intersection occur in the mid-lobe vein. After the dissection of the artery and mid-lobar bronchus is performed. It also affects the lymph nodes of the root Upper lobectomy on the left, located in this area.
Top left
The pleural cavity is opened on 4 or 5 intercostal spaces. Under the root dissect the mediastinal pleura. The pulmonary artery is allocated. The upper vein is treated by hand or hardware. Upper lobar bronchus is dissected in the division into segments.
The cult is sutured and covered with pleura. Bits with the lower lobe are dissected between the clamps, after which the upper lobe is removed.
Lower left
The pleural cavity and the 6 intercostal spaces are opened. The pulmonary ligament is ligated and dissected. The slit is wide open. Displays the mediastinal pleura over the lower pulmonary vein. The short lower lobar bronchus is dissected slightly above the site of division into the bronchi of the basal segments.
Removal of the lower lobe with bronchiectasis is sometimes combined with the elimination of affected ligament segments.
Lower right
Occurs in several stages:
- Autopsy of the pleural cavity on the sixth intercostal space.
- Dissection and ligation of the pulmonary ligaments.
- Opening of an oblique slot.
- Arterial ligation.
- Lowering the lower lobe.
- Determination of the point of departure for medium bronze.
- Isolation of either the lower lobar bronchus or the bronchi of the basal segments.
- Cults are biting.
- The jumper is split.
On the video, the lower lobectomy of the bronchus on the right:
Postoperative period
In the early days, aspiration is constant. The patients are allowed to sit down on the second day, after another day, they can be put.
Lobectomy of the brain
It is aimed at removing the pathological portion of the lobe of the brain. Access and volume depend on the location of epi-activity, the tumor or its prevalence.
Electrocorticography is used during the operation. It allows you to record the encephalogram from the cerebral cortex and determine the desired site.
During the operation, the hemispheres are divided into 4 sections. Lobectomy has high rates. In 90% of cases, the frequency of seizures decreases by 95%.Surgery for temporal lobes is more common in adolescents and adults.
During manipulation, part of the brain tissue is removed. Most often, surgeons pay attention to the anterior and medial part of the temporal lobe.
Thyroid gland
Lobectomy is considered one of the safest manipulations. It is performed with a solitary dominant node, which is suspected of having malignant cells. It is also carried out in case the biopsy was not informative.
Lobectomy is also common with the removal of the isthmus. The surgeon removes the lobe of the gland, the isthmus connecting the lobes. The operation is applied when you need confidence that the entire affected part will be deleted.
The standard incision is up to 12 cm. Currently, incisions are less than 6 cm. Then part of the affected gland is removed. It is important that the return nerve responsible for voice is not affected.
Liver
Distinguish left and right sided lobectomy. After opening, the peritoneum mobilizes the liver, overlaps the retaining ligaments and processes the corresponding artery.
Dissect the parenchyma of the liver throughout the thickness. Then remove the affected area. At the last stage, the hemoglobin space is drained.
Advantages and Risks of
The operation allows to preserve the functioning of the body, to reduce the rehabilitation period.
The risk of complications increases if there is a concomitant disease or a patient of advanced age.
Among the risks noted:
- stroke,
- bleeding,
- infection,
- development of renal failure,
- thrombosis.
Videoothoracoscopy is becoming very popular. It increases the degree of security of the operation. At the same time, the radical nature of the interventions is not inferior to radicalism in the traditional types of manipulation.
Price
The price depends on the organ on which the operation is performed.
The cost of some clinics includes hospitalization, tissue biopsy, rehabilitation and other procedures.