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Ward 6 South, Wellington Regional Heart and Lung Unit
Lung Surgery
Information for patients
Your Lung Surgery
Welcome to Wellington Regional Heart and
Lung Unit.
This booklet we have provided is to give you some
general information about your lung surgery and
what to expect during your stay at Wellington
Hospital.
We encourage you and your family to read this
booklet so you will have an idea of what to expect
during your stay with us.
If you have any questions at anytime during
your stay please don’t hesitate to ask nursing or
medical staff. We are only too happy to help.
What to bring with you into Hospital
When you come into hospital we recommend that
you only bring the essentials. We also recommend
that you leave any valuables at home or with a
family member.
If you are unable to do this then we have a safe
available to lock away your valuables. Please
note that the hospital is not accountable for your
belongings. All items are bought into hospital at
your own risk.
We recommend you bring with you your wash bag
with the essentials, eg toothbrush, toothpaste,
soap etc Also your pyjamas, slippers and clothes
that are comfortable for you to go home in.
What to consider after your
Discharge
Some of the following situations may apply to
you after you are discharged from hospital.
Please consider that you may need to make plans
regarding these prior to your admission.
Care at Home- After your operation you will need
someone to care for you at home, or somewhere
to stay for at least a week after you are discharged
home. These arrangements should be made before
your operation. We recommend this for your own
safety and comfort. If you have any problems with
this we have a social worker available on the ward
to assist.
Work- Depending on the work you do, you will
need to take approx 4-6 weeks off while you are
recovering. If your job is physically demanding you
may require longer. We are happy to provide you
with a work certificate for the period.
Driving- You will not be allowed to drive for
approximately one month after your operation;
this is for your own safety. You will need to
arrange someone to collect you from hospital on
discharge and to drive you to appointments etc.
Flying- You will not be allowed to fly for at least
6 weeks internationally after your operation.
You will be able to fly home domestically (for
example if you live in the south island) but it is not
recommended for at least 6 weeks post surgery.
About your Surgery
The term thoracic surgery is a general one used
to describe any surgery within the thorax or chest
area. This is mainly of the lungs.
There are a number of different types of lung
surgery, the most common ones being:
ƒƒ Lobectomy
ƒƒ Pneumonectomy
ƒƒ Pleurodesis
ƒƒ Decortication
ƒƒ VAT’s – Videoscopic Lung Surgery
ƒƒ Lung Biopsy
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Issued July 2012 Review July 2015, ID number 1.100831 and WD6S PIB-01
To get to the lungs the surgeon needs to spread
the ribs, usually in the back of the chest. These
are closed again at the end of the procedure and
will take several weeks to heal.
Generally these operations take between two and
four hours, however this may vary from person to
person according to the difficulty of operation.
Lobectomy
Not all Lung Surgery is for Cancer. Sometimes
lungs collapse (pnuemothorax) or there is a
build up of fluid around the lung. These can also
be corrected with surgery.
These can be due to a;
Pneumothorax
corrected with
a Pleurodesis. A
Pneumothorax is a
collapsed lung.
A lobectomy is
where one of
the lobes of the
lung is removed.
Haemothorax is a
collapsed lung with blood
in it.
Pneumonectomy
Surgical removal
of the whole lung,
leaving the other
lung intact.
Pleural Effusion which
is a collection of fluid
around the lung. If this
solidifies then is called an
Empyema which is also
surgically removed.
What to Expect on Admission
Wedge Resection
Surgical Removal
of part of the lung.
When you arrive at Wellington Heart and Lung Unit
you will be greeted and checked in at reception.
Once this has happened, you will be sent to have
your Pre Operation Bloods taken and a Chest
X-ray.
Once this is done, you will return to the ward
where you will be shown to your bed and the
nurse will start preparing you for your procedure.
The doctor will also do their assessment. You will
also be seen by the anaesthetist who will explain
about being put to sleep and the importance of
pain relief.
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The Surgeon will see you the night before the
operation and they will be able to answer any
questions you may have about your procedure.
If you have any questions then please do not be
afraid to ask.
Day of Surgery
The nurse or doctor will let you know what time
approximately you will go for your operation. You
will go down to theatre on your bed, your family
are able to accompany if you wish.
Once in theatre your operation will be between 2-4
hours depending on the procedure. The surgeon
will contact your family after the procedure has
been completed. Once the surgeon has finished
then you will go to recovery room (PACU). You will
remain here until you wake up properly and the
pain is well controlled.
You may spend a long period in PACU post surgery,
between 2-4 hours until the pain is well controlled.
Your family are welcome to contact the ward about
your recovery but will not be able to go to PACU
during this period.
Once PACU is happy you will be discharged back to
ward 6 South to continue with your recovery.
You will be attached to a cardiac monitor overnight
and have your vital signs such as BP checked
frequently. This is normal post operative care.
You may feel very sore post operatively but the
nurses and doctors will attempt to keep you as
pain free as possible.
Pain Relief
Pain management is very important post surgery.
There are many different types of pain relief
available and these will be discussed with you by
the anaesthetist before your operation. Different
types include;
ƒƒ Epidural
ƒƒ PCA – Patient Controlled Analgesia
ƒƒ Wound Catheter
ƒƒ Paravertebral Catheter
ƒƒ Oral Analgesia
It is very important to have your pain well
controlled so you are able to do your deep
breathing exercises and cough. You can discuss
the different types of pain relief with the doctors
and nurses on your admission.
Urinary Catheter
A small tube is placed into your bladder to drain
urine continuously. This is so staff are able to
monitor your kidney function post surgery. Also
with thoracic surgery the urinary catheter is put
in place with the use of an epidural. The epidural
numbs the area below the incision site and inhibits
bladder function. This will return to normal once
the epidural is removed.
Intravenous Lines
These allow you to receive fluids and medications
including some pain relief. You may have 2-3 lines
in your arms post surgery. These will stay in place
a maximum of 72hrs for each line and will be
removed once no longer needed.
Circulatory Stockings
Post Surgery
Intercostal Tubes (Chest drains)
After your operation you will have chest drains
to remove any excess fluid or air from around
your lungs. These will stay in situ until they stop
draining fluid or no more air is in the chest.
The Apical drain in the top of the chest will remove
any air and the Basal drain in the bottom of the
lung will remove any fluid that will build up in the
chest.
You will be fitted with a pair of white stockings on
admission that you will need to wear all the time
except for when they are in the wash briefly. You
will need to wear them until you are back to your
usual level of activity at home. These stockings
promote blood flow and prevent clots from
forming. They also reduce any swelling in your feet
and ankles. You may need assistance with putting
the stockings on and off.
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Your Recovery
You will be with us in 6 South for approximately
a week during your recovery but that will be
dependent on how long your Chest Drains stay in
situ and how well the pain is controlled.
It is very important that you continue with your
pain relief. You should be able to deep breath and
cough with little discomfort. If this is not possible
ask your nurse to see if additional analgesia is
available.
This allows the social worker to be informed
as soon as possible, so your discharged is not
delayed.
Diagnosis
If you have had a biopsy or a part of your lung
removed you may have had the results prior to
discharge or you may still be waiting when you go
home.
You will be short of breath after your operation,
but this will diminish over time as your body
adjusts. Especially if you have had part or a whole
lung removed as your lung volume has been
reduced.
Biopsy and Pathology results take time as they
need to be carefully analysed by the pathologist.
We endeavour to inform you as soon as possible
the results of biopsies. This can be a very
stressful time so please feel free to express
yourself and your concerns to the nurses or the
social workers.
It is also essential you continue with the exercises
that the physio have explained to you as this will
aid your recovery. Not doing your exercises will
affect your chest and could also induce ‘frozen
shoulder’.
Once your results are available you will be
contacted by your GP. They will be able to inform
you of the outcome and the steps to take after
hearing your results.
Going Home
If required and further treatments will not
commence until 4-6 weeks after your operation to
allow you to fully recover.
When you go home the nurse will explain
everything you need to know.
Wound care is particularly important. You can
shower normally once you are home. Do not rub
any soaps, cream, moisturiser or talc into your
wound until it has completely healed. Pat your
wound dry with a clean towel.
If you notice any redness, swelling or discharge
then please see your GP.
As many stitches as possible are removed prior
to discharge. You will have stitches in place from
your chest drains which your GP will remove. We
recommend you see your GP one week after you
are discharged from hospital.
They will assess your wound, remove any stitches
and ensure your medication is working effectively.
The stitches in your thoracotomy wound are
dissolvable.
If you have any social concerns about going home;
including financial assistance, living alone, home
help etc please inform your nurse on admission.
Discharge
On discharge you will be given a discharge
summary explaining what has happen during
your time with us and the plan for follow up
appointments.
Follow up appointment is usually 6 weeks post
your procedure at either Wellington hospital with
the Cardiothoracic Surgeon or your local hospital
with the Respiratory team.
This appointment will be sent to you in the post.
You will receive your prescriptions on discharge;
you will need to go to a local pharmacy to fill your
prescriptions. There is no pharmacy at Wellington
Hospital.
If you are not being transferred to another hospital
or were transferred to Wellington Hospital you will
need to make your own arrangements for your
transport home.
If you have problems with work, travel or family
needs or are feeling worried about other issues,
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please inform your nurse on admission and they
will refer you to the social worker if appropriate.
Notes
If you need a work certificate then please inform
the nurse prior to discharge and they will be happy
to arrange this.
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Information for Families
We understand this is a very stressful time for you
and the nursing staff are happy to help.
There is tea and coffee available for visitors in the
Whanau rooms located just outside 6 South. They
are stocked regularly but if anything is missing
inform your nurse and they will be able to get it
for you.
There is also Wishbone café located in the atrium
on level 2 as well as the hospital shop. Fuel coffee
is also available on level 3 at the Mein Street
entrance.
After surgery your loved one will be in recovery,
so once the surgeon has contacted you they will
not return straight to the ward. You are more than
welcome to contact the nurses on 6 South and
they will be able to inform you if your loved one
has returned from recovery to the ward.
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We also regret to inform you that we do not allow
family members to stay overnight during hospital
admissions. We have visiting between 10am - 1pm
and 3pm – 8pm. Between 1pm – 3pm we have
patient rest period which is strongly enforced on
6 South, no visitors will be allowed in during this
period.
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If you have any questions please ask the nurses
and they will answer your questions as best
possible.
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