Initial Consultation And History
The evaluation process begins with a detailed consultation with the thoracic surgeon. The doctor will review the complete medical history of the patient including smoking history occupational exposures and previous surgeries.
For lung issues they track symptoms like cough shortness of breath or coughing up blood. For esophageal issues they assess difficulty swallowing or weight loss. This initial step establishes the need for surgery and identifies any potential risks. The doctor will explain why robotic surgery is the recommended course of action based on this history and perform a physical examination.
Functional Imaging With Spect CT
Spect CT or Single Photon Emission Computed Tomography combined with CT provides functional information about the organs. It is particularly useful for evaluating lung function before surgery. By showing which parts of the lung are contributing most to breathing it helps the surgeon predict how well the patient will breathe after a portion of the lung is removed. If a patient has poor lung function removing a large section via Robotic Lung Surgery might be risky so this test helps define the safe limits of resection.
The Role Of Scintigraphy In Evaluation
Scintigraphy also known as a V/Q scan is a nuclear medicine test used to evaluate air flow and blood flow in the lungs. It is a standard test for patients with borderline lung function who are being considered for lung resection. A radioactive tracer is inhaled and injected to map the function of each lung lobe. This quantitative data allows the surgeon to calculate the predicted post operative lung function. This test ensures that the surgery is performed on patients who will have sufficient lung capacity to live comfortably afterwards.
Bronchoscopy And EBUS
Before proceeding with Robotic Lung Surgery it is often necessary to look inside the airways. Bronchoscopy involves passing a flexible camera down the throat into the lungs to visualize the tumor. Endobronchial Ultrasound or EBUS uses a special scope to see through the airway walls and sample lymph nodes in the center of the chest. This biopsy confirms the diagnosis and checks for spread to the lymph nodes. Knowing the exact status of the lymph nodes is crucial for determining the stage of the cancer and the extent of surgery required.
Pulmonary Function Testing
Before undergoing thoracic surgery patients must undergo a comprehensive evaluation of their breathing capacity. Pulmonary Function Tests or PFTs measure how much air the lungs can hold and how quickly air can be moved in and out. These tests also measure how well oxygen moves from the lungs into the blood. The results help the surgeon and anesthesiologist determine if the patient can tolerate the loss of lung tissue and the stress of single lung ventilation during the robotic surgery.
Cardiac Stress Testing
Robotic thoracic surgery places specific demands on the heart. During the procedure one lung is deflated to create space for the robot to work which increases the workload on the heart. Therefore a cardiac stress test is often performed. This helps identify any underlying heart conditions that might cause complications during surgery. An echocardiogram may also be done to check heart valve function and pressure in the lung arteries. Ensuring the heart is strong enough is a critical safety step.
Blood Work And Anesthesia Assessment
Routine blood tests are conducted to check for anemia kidney function and clotting ability. Anemia is common in cancer patients so correcting hemoglobin levels before surgery is important. An anesthesiologist will review the airway and allergy history of the patient. Medications such as blood thinners must be stopped in advance to minimize bleeding risk. This comprehensive assessment ensures maximum safety during the operation and smooth recovery from anesthesia.
Pre-Operative Instructions
In the days leading up to the surgery patients receive specific instructions. This may include breathing exercises to strengthen the lungs and smoking cessation which is mandatory to reduce the risk of pneumonia. Patients will be told to stop eating and drinking after midnight the night before the surgery. Following these rules is critical to prevent aspiration during anesthesia and to avoid cancellation of the surgery.