What to Expect - Thoracic Robotic Surgery

What Incisions Will I Have?

If you undergo robotic thoracic surgery at Cottage you will have four small robotic arm incisions and one large incision (about four inches) to extract the specimen.

Typically, the surgeon will insert one chest tube at the end of surgery to drain fluid and air from inside your chest. All of your incisions will be closed with dissolving stitches so you will not need to have stitches removed once you leave the hospital.

In order to give your surgeon the complete picture of you and your overall health, and to determine if robotic surgery is the best option, you will need to have the following tests:

• Lab Work - There are a variety of blood tests that need to be done in order to evaluate your overall health and different organ function.
• Pulmonary (Lung) Function Test - A breathing test to measure how well your lungs are working.
• Radiographic Imaging - Depending on what condition you have one or more of the following scans will need to be done: CT, MRI, X-ray, or PET scan.

Night Prior to Procedure

You will receive instructions at your preoperative appointment, usually done the day before your procedure. Instructions will be provided on proper bathing techniques and a guideline as to which medications you can take the morning of your surgery.

You will not be able to eat food after midnight on the night before the procedure but you can continue to take small sips of water up until 3 hours before the procedure time. The carbohydrate drink provided at your preoperative appointment should be consumed and finished 3 hours before the scheduled surgery time.

This is important to aid with better glycemic control during the surgery.

Day of Procedure

• After fasting overnight (other than the liquids mentioned above), arrive at Santa Barbara Cottage Hospital at your scheduled time.
• You will meet your anesthesiologist, nurse, and surgeon before your procedure to make sure that you are prepared and that all your questions are answered.

Immediately After Your Robotic Thoracic Surgery

• You will stay in the Post Anesthestic Care Unit (PACU) for one to two hours then transferred to the general hospital floor when you are awake and stable.
• The breathing machine (ventilator) is normally removed immediately after the surgery while you are still in the operating room.
• You may start to take in ice chips or clear liquids, and begin eating once you feel ready.

Day 1 After Your Procedure

• The surgical team will see you in the morning and go over how you are doing and answer any questions you may have.
• Your home medications will be restarted.
• You will be evaluated by physical therapy and encouraged to walk and move about with help.
• We may remove your foley catheter (to drain your urine) if you still have one.
• You will be encouraged to drink and eat.

Day 2+ After Surgery

• The surgical team will continue to see you every morning and assess how you are doing and answer any questions you may
  have.
• We will make sure you are going to the bathroom and eating/ drinking normally.
• You will receive information and instruction for your home arrival, as well as your medications and follow-up.
• We will make a follow-up appointment for you to see the surgeon 2-3 weeks from when you were discharged.

Recovery While Home

• It is normal to experience shortness of breath and fatigue for the first few weeks while doing activity. It is crucial that you try to walk every day to keep the lungs expanded and to promote quick recovery.
• Incisions: keep your incisions covered and dry for 48 hours and afterwards, there is no need to cover your incisions with gauze or use lotion/cream. Numbness and tenderness around your incisions is normal and can last for six to eight weeks. When you shower, you can get the incisions wet. It is important to not scrub the incisions and only use a towel to gently pat dry.
• Driving and returning to work: Do not drive until you are off all pain medications. You should also be able to fully move your shoulder and arm if you are going to drive. As for work, you can expect to be out of work for two to four weeks depending on the type of work you do. Your surgeon will let you know when it is safe to return to work.
• Lifting: No heaving lifting or carrying anything more than 10 pounds for four weeks. This will allow your incisions to heal fully.