Thoracic Surgery
Lung or chest surgery including lobectomy, pneumonectomy, and VATS (keyhole procedures).
About your surgery
Types of thoracic surgery
Thoracic surgery is done either through a keyhole approach (Video-Assisted Thoracoscopic Surgery, or VATS) or through an open incision between the ribs (thoracotomy). Your surgeon will discuss which is most appropriate for you. Common thoracic operations include:
- Wedge resection — removing a small section of lung
- Lobectomy — removing a whole lobe of the lung
- Pneumonectomy — removing an entire lung
- Bullectomy — removing large damaged air sacs (bullae)
- Pleurodesis or pleurectomy — treating a collapsed lung or fluid around the lung
- Mediastinoscopy — examining and sampling the space between the lungs
What to expect
Your Journey
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Before surgery
Start your deep breathing exercises as soon as possible (see our Prehabilitation guide). This can significantly reduce your risk of developing a breathing complication after your surgery.
Before lung or chest surgery you will usually have breathing tests (such as spirometry and gas transfer, or DLCO) to check your lung function, and sometimes a walking test or cardiopulmonary exercise test (CPET) to assess your fitness for the operation.
You will also be invited to a pre-assessment appointment in the weeks before your operation. See our Anaesthesia guide for what to expect. -
The day of surgery
Depending on your operation and hospital, you may be admitted the afternoon before or on the morning of surgery. You may have pre-operative tests such as blood tests or a chest X-ray. Your surgeon will go through consent and the surgical plan, and your anaesthetist will visit to discuss your anaesthetic and pain relief.
Thoracic surgery is performed under general anaesthesia, usually with an epidural or paravertebral catheter (a fine tube in your back) placed to manage pain afterwards. See our Anaesthesia guide for more.
You will wake in the Post Anaesthesia Care Unit (PACU). You may have several of the following in place:- a drip (IV) for fluids and medicines
- one or more chest drains
- an epidural or paravertebral catheter
- a urinary catheter
- a patient-controlled analgesia (PCA) button to give yourself pain relief
- oxygen through a mask or nasal prongs
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In hospital
From the PACU you move to a closely monitored area (sometimes called a step-down or high-dependency unit), where your vital signs, drains, and pain are checked regularly. As you need less monitoring, you move to a standard ward bed. Each morning the surgical team will visit to assess your progress and plan the day.
Getting up and moving as soon as it is safe is one of the most important things you can do for your recovery. A physiotherapist will help you. Do your deep breathing exercises.
Pain relief
Good pain control is essential: it lets you breathe deeply, cough, and move, which helps prevent chest infections. You will usually have regular paracetamol plus a PCA (morphine or fentanyl). If you have an epidural or paravertebral catheter, the pain team will check it each day. Pain relief is gradually reduced once your chest drains are out.
Chest drains
Chest drains remove fluid and air and help your lung re-expand. Nurses check them regularly and may ask you to take a deep breath and cough. Drains are removed once your surgeon is satisfied, followed by an X-ray to confirm your lung has re-expanded.
Cultural and pastoral support
Support is available throughout your stay, including Whānau Care Services for Māori patients, Pacific health support, and multi-faith chaplaincy. Ask staff if you would like a referral. -
Going home
Your team will give you clear written guidance on wound care before you leave and arrange a follow-up appointment (usually within 2 to 6 weeks).
Take your pain relief regularly for at least a few weeks, including at night. Reduce the dose gradually, stopping paracetamol last.
Exercise is an essential part of recovery. Start gently and build up; you should be able to hold a conversation while exercising. On the side of your wound, avoid lifting, pushing, pulling, or carrying anything over 6 kg for the first 4 to 6 weeks.
Most people need 6 to 8 weeks off work (longer if your job is physically demanding). You can usually drive again around 4 weeks after surgery, once you can steer and brake comfortably.
If you are planning to fly, check with your surgical team first. The timing depends on your operation and how well your lung has recovered.
Contact your GP or surgical team if you develop a fever, signs of wound infection, or pain that your medication is not controlling. Get urgent help (your nearest emergency department, or call 111) for chest, arm, or throat tightness, dizziness or feeling faint, sudden confusion, or severe or worsening breathlessness, especially with chest pain.
The people around you
Who looks after you
A lot of people are involved in getting you safely through an operation. Knowing who does what can make the whole experience feel less unfamiliar.
Your anaesthetist
Anaesthetists are specialist doctors who are trained in anaesthesia, pain management, and the care of seriously unwell patients. You will meet yours before the operation: they will go through your health, explain the plan, and answer any questions.
During surgery, your anaesthetist stays with you the whole time. They give the medications that keep you under anaesthesia and free of pain, and continuously monitor your breathing, heart, blood pressure, and fluids as the operation is happening. Afterwards they plan your pain relief, so you can breathe deeply, move, and recover. If you are worried about anything at all, tell them. Helping you through this safely and comfortably is their entire job.
Your surgeon
Surgeons are specialist doctors. You will usually meet yours first in clinic, to talk through whether surgery might be a helpful treatment option, what the risks are, and what happens if you choose not to have an operation. Sometimes an anaesthetist and other specialists are involved in these decisions too. Your surgeon performs your operation, and after surgery their team looks after you on the ward and plans your follow-up.
Pre-assessment nurse
Sees you in the weeks before surgery to review your health, medications, and test results, and to make sure everything is ready for the day. A good person to ask early questions.
Anaesthetic technician
A specially trained member of the theatre team who works alongside your anaesthetist, preparing and checking equipment and helping care for you throughout the operation.
Theatre and PACU nurses
Theatre nurses help to look after you, assist the surgeons, manage surgical equipment, and ensure everything runs smoothly. In the Post Anaesthesia Care Unit (PACU), specialised nurses monitor you closely as you wake and treat pain or nausea straight away.
Ward nurses
Your day-to-day carers in hospital: medications, wound care, and keeping an eye on your progress. They are your first port of call whenever something doesn't feel right.
Physiotherapist
Helps you recover movement and function after surgery. What this looks like depends on your operation: it might be breathing exercises to protect your lungs, joint exercises after a replacement, or simply helping you walk safely again. Getting moving is one of the most important parts of recovery, and they will guide you from your first steps out of bed.
Hospital pharmacist
Checks your medicines when you arrive and when you leave, making sure nothing is missed and your discharge medications are right.
Cultural and pastoral support
Most hospitals offer support for you and your whānau throughout your stay, including Māori and Pacific health services and chaplaincy for all faiths and none. Ask any staff member for a referral.
Build your prep plan
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