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RATS Sleeve Lobectomy Scheduled 7/13


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Hi all

I've found some great tips on recovery and expectations on this site for VATS/RATS lobectomy.  Any more would be appreciated!

I now have my surgery scheduled for 7/13.  I had the privilege to interview 3 surgeons, and all 3 had different approaches to sleeve resections.  It seems through these discussions, and some research online, that the RATS systems offer a pretty significant advantage in regards to being able to perform this type of surgery without having to do full open surgery.  One surgeon would only do a thoracotomy, the second surgeon would plan for VATS but candidly said wouldn't know until they opened me up if they could do the procedure that way, or if they would need to switch, and the RATS surgeon said he was certain he could do the procedure with the minimally invasive incisions... 

Anyway- I thought it was pretty interesting how different the 3 strategies were, and I think the technology just allows them to not need quite as much space, which in my particular case ends up being kind of a big deal.  Does anyone have any experience with the robot VATS recovery?  It seems to be pretty similar to traditional VATS from what I've seen.

None of them were certain if it would be a RLL lobectomy, or if they would also need to take out the RML.  The airway runs pretty close to the intersection, and obviously the higher priority is clean margins, so they will test during the surgery and do their best to save lung while prioritizing getting it all out with clean margins.

Mentally, after now over 2+ months since tumor discovery, still not having a firm diagnosis of what the tumor exactly is, having been through both flexible and rigid bronchoscopes etc... I feel ready for the surgery, and to have this part of the journey behind me.  

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I think you've really done your due diligence interviewing 3 surgeons. I sense you are seeking a degree of certainty in terms of techniques, scope and outcomes and while I wish you certainty, I hope for a successful outcome regardless of the technique or method. I know you've like read Lou's tips and tricks for lung cancer survival, here. This is the best collection of suggestions post surgery I know of.

While I wish you certainty, know that your surgical reality only allows degrees of certainty. I know, that sucks. But I think it is important to come to grips with lung cancer reality because uncertainty is our, now your, way of life. I would add one suggestion. If a medical oncologist recommends post surgical chemo, then take it. (Of course, you have a medical oncologist on your team, right?) Most surgeons will say "I got it all" and that means "I got everything I could see." Survival is increase when we throw everything at the disease early. I know so many who have good surgical outcomes and a recurrence after surgery who declined post surgical chemo. Don't be one of those. Endure the small discomfort for the larger benefit of extended life.

Stay the course.


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Hi Walfredo, I had VATS lobectomy in April. My surgeon was top notch and very famous but he also alerted me that they may have to open if anything unexpected happens but that it was rare in his hands (nothing did). Surgeons are like artists, very different than oncologists, who follow protocols. A surgeon works according to their skills and preferences, some find RATS better since it helps them be steady. Others are super skilled, they feel they don't need a robot and may find it restrictive. I chose my surgeon by reputation and meeting him confirmed not only his competence but his sheer niceness and unparalleled bedside manners. How I wish my oncologists were a fraction of his humility and humanity.

If it is cancer, I second Tom's suggestion to follow surgery with chemo. Also push for mutation testing to see if your cancer is targetable. Best of luck!

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Thanks Tom and Lilly,

I appreciate all the input. I do have an oncologist on my team, but won’t get to meet them prior to surgery. First appt is scheduled for 7/18, so hopefully a few days after I’m out of the hospital. 

The first Mayo report calls it a low grade spindle cell neoplasm of unknown type and biological potential…. That along with the high fdg activity sort of screams cancer… but they aren’t sure what. Mayo has been doing molecular testing the past 2.5 weeks and are supposed to issue a second report based on those findings. Hoping they have more info prior to oncologist appt. Kinda feel like they won’t have much to go on at this point. Could be sarcoma, could be carcinoma… could be?

I think if having a simpler resection I would have chosen the second surgeon who specializes is VATS and is very highly regarded.  It does seem like the robot has some real advantages to my particular surgery and the likelihood of minimally invasive.  The RATS said less then 1% chance he has to switch to open, the VATS lady said more likely then not she could do VATs.  Say 51-80%ish is how I took it.  

I definitely am open to chemo, I’m 41 and in good health, so anything I can do now to lower odds of reoccurrence I’m all in.  


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