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The lungs exchange oxygen for carbon dioxide, transferring oxygen from the environment to the blood and carbon dioxide from the blood to the environment. The body tissues need oxygen for proper metabolism and the body tissues create carbon dioxide as metabolic waste.
Thank God for plants, which do the opposite!
The mouth gives rise to the larynx, which is connected to the trachea. The trachea splits, giving rise to the left mainstem bronchus and the right mainstem bronchus. These bronchi then split into smaller bronchi.
Ultimately, the bronchi split into very tiny divisions called alveoli. The blood vessels in the lungs are also very tiny and the oxygen and carbon dioxide are exchanged where the alveoli and blood vessels meet. There are about 500 MILLION alveoli in the lungs.
In addition to these divisions of the airway, the lungs are divided into lobes. These are large divisions with natural planes of separation called fissures. There are 3 lobes on the right side and 2 lobes on the left; the heart takes up some space on the left side.
The natural divisions of the lung facilitate certain operations. This is because cutting across the lung through the middle of the lung can damage the lung. But with a lobectomy, the lung tissue doesn't have to be cut much, because the fissures are already naturally divided.
In addition, if the lung has a cancerous nodule or mass, a lobectomy is often the appropriate operation. This is because cancer in the lung tends to spread to the lymph nodes first.
Taking out the lobe in which a cancer has developed allows for the lymph channels near the mass to be removed. So, if any cancer cells are beginning to migrate away from the mass, they are likely to be removed with a lobectomy.
For a cancer confined to a lobe, there has never been shown to be a better therapy for long-term success from the cancer than lobectomy.
A person with normal lung function can usually tolerate a lobectomy. In fact, a person with normal lung function can usually tolerate a pneumonectomy, which is removal of an entire lung. It is rare to perform a pneumonectomy, however.
Prior to lobectomy, Dr. Pool asks patients to undergo pulmonary function testing, in order to confirm that the patient can undergo lobectomy. This is a simple test that involves blowing forcefully into a sensor that can measure the amount of air blown out. This test is not invasive and is not painful.
Dr. Pool uses the daVinci robot for almost all of the lobectomies he performs.
Robotic lobectomy is performed with a general anesthetic.
Robotic lobectomy usually takes Dr. Pool 1-2 hours to perform.
A drainage tube is inserted at the end of a robotic lobectomy.
The 10X magnification of the robot camera allows for excellent visualization of the lung and thoracic anatomy.
Branches of the pulmonary artery and vein and the bronchus - where the air moves - are divided, allowing the lobe to be detached and removed.
Most patients go home in 2-3 days, after the drainage tube is removed. Dr. Pool has had a number of patients go home after 1 night, if the lung is not leaking any air after operation.
Dr. Pool has performed many robotic lobectomy operations. Any of the 5 lobes of the lung can be taken out with a robotic technique, and Dr. Pool has extensive experience with all of them.
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