Juwak, Jassim A.

BSN – B
NCM112j – Respiratory
08/29/2022

Lung Segmentectomy
A lung segmentectomy is a surgical operation that tries to remove sick tissue from the
lung while preserving as much healthy lung tissue as possible without causing any
damage to it. During a lung segmentectomy, the only portion of a lung lobe that is
removed is that which is affected by the disease.
Preparation
 Inform the patient that they should make arrangements to have any blood tests or
other tests that have been prescribed by the attending physician.
 Encourage the patient to give up smoking because doing so will lower their risk of
developing difficulties.
 Notify the treating physician of any and all medications, including over-the-counter
and prescription drugs, vitamins, and herbal supplements that the patient is
currently taking. This includes aspirin. Before undergoing surgery, the patient could
be instructed to stop taking certain medications on the doctor's advice.
 Advise the patient not to consume anything by mouth after the stroke of midnight
on the night before the procedure, unless otherwise instructed.
 On the day of the operation, it is important to remind the patient to check in at the
hospital on time.
Procedure
In most cases, a segmentectomy will take between three and six hours. During this portion
of the operation, the doctor will:
1. An incision is made in the patient's chest, and their ribs are spread apart.
2. Carries out the intended excision of the lungs.
3. The incision is stitched up.
What to Expect
Under general anesthesia, a lung segmentectomy can be performed two ways:
Open Surgery - During an open lung segmentectomy, the surgeon makes an incision
between the ribs and below the armpit. The surgeon will then remove the diseased lung.
Minimally invasive surgery - Video-assisted thoracoscopic surgery allows minimally
invasive lung segmentectomy (VATS). A VATS procedure involves three small chest
incisions. A camera-equipped thoracoscope is inserted into the chest. The surgeon will
collapse the diseased lung using other incisions. Diseased lung tissue is removed, excess
fluid and air are drained, and the lung is reinflated. The incision is closed after the lung is
inflated.
Treatment
After a VATS lobectomy, here's what the patient needs to know:
 Stick to modest frequent meals and drink plenty of water if the patient has a bad
appetite.
 Driving: 2-4 weeks after surgery, but check with the doctor beforehand.
 Appointments with the oncologist and surgeon are needed two and six weeks after
surgery.
 Pulmonary rehab — Expect a sluggish recovery for the first few weeks (it will start
feeling 'normal' about 4-6 weeks after surgery), and we recommend attending a
pulmonary rehabilitation program to aid in the recovery.
 It's natural to feel fatigued for at least the first week, so take frequent breaks.
 Someone must be home for the first several days to aid with lifting (shopping,
washing, vacuuming, making beds)
 One week after surgery, the doctor will call you with test results.
 Work – It may require 2-4 weeks leave, so discuss work plans with the doctor and
get a medical certificate if needed.
 Know these wound care tips:
 Wounds heal in four weeks:
- It may be necessary to shower everyday and wet the wounds, but don't
soak them; pat them dry and avoid applying lotions or powders.
- Up to a few months, wounds may feel numb, tingly, or pins and needles.
- Drain incision inflammation is common. Hospital discharge antibiotics
prevent infection.
Nursing Responsibilities
Before Procedure Management

 Inform the patient about anesthesia, segmentectomy, and postoperative chest

tubes and drains.
 Tell the patient about postoperative oxygen and a ventilator.
 Turning frequently promotes lung drainage.
 Teach incentive spirometry and diaphragmatic and pursed-lip breathing.
 Teach the patient to splint the wound using hands, a cushion, or a towel to reduce
pain.
 Evaluate the patient's feelings about the illness and operation.
 Correct any misconceptions, support the patient's decision to undergo surgery,
and answer concerns honestly about pain, suffering, and therapies.
After Procedure Management

 Regularly check vital signs

 Cannula, mask, or ventilator deliver oxygen as needed.
 Low-rate fluids prevent fluid excess and pulmonary edema.
 Elevate the patient's bed 30 to 45 degrees.
 To prevent mediastinal displacement, turn from back to operated side, but not
totally.
 Administer painkillers. Promote incision splinting.
 Breathing exercises and spirometry help lung ventilation.
 Check for cyanosis, dyspnea, and chest pain.

References
Lung Segmentectomy | Lung Cancer Care | Mercy Health. (n.d.).
Https://Www.Mercy.Com/Health-Care-Services/Cancer-Care-
Oncology/Specialties/Lung-Cancer-Treatment/Treatments/Lung-
Segmentectomy#:~:text=A%20lung%20segmentectomy%20is%20a,Of%20a%20lung%
20is%20removed. https://www.mercy.com/health-care-services/cancer-care-
oncology/specialties/lung-cancer-treatment/treatments/lung-
segmentectomy#:%7E:text=A%20lung%20segmentectomy%20is%20a,of%20a%20lung
%20is%20removed.
Mn, A. J. D. R. N. (2012, September 21). Lobectomy. Nursing Crib.
https://nursingcrib.com/nursing-notes-reviewer/medical-surgical-nursing/lobectomy/
Video Assisted Thoracoscopic Surgery (VATS) Lobectomy - St Vincent’s Lung Health.
(n.d.). Https://Www.Svhlunghealth.Com.Au/Procedures/Procedures-Treatments/Video-
Assisted-Thoracoscopic-Surgery-Vats-Lobectomy/Video-Assisted-Thorascopic-Surgery-
Vats-Lobectomy. https://www.svhlunghealth.com.au/procedures/procedures-
treatments/video-assisted-thoracoscopic-surgery-vats-lobectomy/video-assisted-
thorascopic-surgery-vats-lobectomy