A surgical lung biopsy is an operation which is used to get samples of lung tissue. This is done to diagnose types of lung disease, it does not help symptoms of the lung disease. The operation is done with you asleep under a general anaesthetic. It is a bigger procedure than needle biopsies, you will need to allow time for recovery.
It is usually a keyhole (VATS) operation and takes about 1 hour. During surgery you lie on your side with your arm raised. Up to 1-3 small cuts are made, each about 1 cm long. These are used for the instruments and small camera to go into the chest. Special staples are used to cut and seal parts of lung that need to be removed for testing. The pieces of lung can be removed through one of the small cuts. The wound is closed with dissolvable stitches. 1 chest drain is put in at the end of the operation and held in placed with a stitch. This removes any fluid or air from around the lung.
If there is a problem during the operation a bigger cut may be needed (thoracotomy). This cut is one larger incision under the shoulder blade, the incision goes between 2 ribs. The 2 ribs are parted to get into the chest. One rib may be cut to give more space, ribs are not removed. At the end of surgery the 2 ribs are held back together with strong stitches. The muscles and skin are also stitched back together.
Most people will be able to go home between 1 and 4 days after surgery.
Results will normally be sent to the doctor who referred you for a biopsy. It takes at least 2 weeks for the laboratory to do basic tests on the lung but it may take much longer to get the final result. Once results are available the next steps in treatment will be discussed with you in clinic.
Air leaking from the lung into the chest drain for a few days is common after lung surgery. Occasionally this lasts for longer, possibly weeks. A chest drain will need to be in place until this settles, you may be able to go home with the chest drain still in and come back for regular check-ups until the air leak settles.
Wound infections are rare.
Infections in your lung are uncommon. You will be advised to mobilise early out of bed to avoid this happening. breathing exercises will also be explained to you to lessen the chances of a chest infection.
Funny heart beats can be felt but they usually settle on their own. Sometimes medicines are needed to calm them down.
Major less common risks
The chance of not making it through the procedure is less than 1 in a 100.
Having a diagnosis can guide which treatments would be best for you. It can also give you an idea of what to expect from the disease, including symptoms or whether the disease may shorten your life.
If you do not want to have an operation to get a diagnosis other options may include:
- Relying on existing tests (such as scans) to judge which disease is most likely
- Repeating a previous test
- Continuing close observation
It is your choice whether to go ahead with surgery or choose another kind of treatment. We will respect your wishes and support you in choosing the treatment that suits you. You are always welcome to seek a second opinion.