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Thoracotomy: Before Your Surgery

What is a thoracotomy?

A thoracotomy (say "thor-uh-KAW-tuh-mee") is surgery done through a cut (incision) in the chest wall between the ribs. The doctor is able to operate inside the chest through this incision. A thoracotomy may be used for surgery on the lungs, esophagus, trachea, heart, aorta, or diaphragm. The exact placement of the incision depends on the reason for the surgery. It is usually across the side of the mid-chest.

In order to spread the ribs far enough to do the surgery, your doctor may need to cut through a rib or the breastbone (sternum). When the surgery is finished, the doctor will close the incision with stitches or staples. If a rib or the breastbone was cut, the doctor will use wire to hold the pieces of bone together as they heal.

Most people spend 3 to 7 days in the hospital after this type of surgery. You will be quite sore after chest surgery. You will get medicine to help with this. Even though you will be sore, it is very important to breathe deeply and be as active as possible after surgery. This will help your lungs expand again and help you heal more quickly. It is important not to smoke after surgery.

The amount of time you will need to recover at home depends on the type of surgery you had. You will probably need to take at least 1 to 2 months off work.

How do you prepare for surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines and natural health products you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance care plan. If you don't have one, you may want to prepare one. It lets others know your health care wishes. It's a good thing to have before any type of surgery or procedure.

What happens on the day of surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be cancelled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Follow your doctor's instructions about when to bathe or shower before your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
  • The surgery will take about 2 to 4 hours.
  • You may stay in the ICU for the first 1 or 2 days after surgery.
  • You will have a tube down your throat during surgery to help you breathe. This will probably be removed before you are fully awake.
  • You will probably have one or two tubes coming out of your chest to drain fluid and air so that your lungs can expand again after surgery. The chest tubes will be removed before you go home.
  • You may have an epidural catheter. This is a tiny tube that delivers pain medicine directly into the area in your back around your spinal cord. The epidural will help prevent pain after surgery.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your surgery.
  • You become ill before the surgery (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the surgery.

Where can you learn more?

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