Thoracotomy

This is the method most surgeons have been trained to perform. The patient is placed on their side and the surgeon enters the chest by going in between the ribs and spreading the ribs.

The advantage with this approach is that the surgeon has great exposure and control over all aspects of the surgery. Often, difficult cases can only be done with this approach. Lymph nodes around the lung can easily be removed with this approach, to look for any cancer cells that may have spread.

The disadvantage with this approach is pain. Injury to the ribs is painful. Anyone who has experienced bruised ribs will agree. The pain is actually caused by the trauma to the nerves between the ribs after spreading them for the procedure. The pain can last for months and, in extreme cases, patients might require referral to a pain clinic for management . The hospital stay is usually longer, with an average of 7 days.