Minimally invasive surgery (MIS) for lung cancer: what does it involve?

Written in association with: Mr Marco Scarci
Published:
Edited by: Aoife Maguire

What is minimally invasive surgery (MIS) for lung cancer and what are its advantages? Highly respected consultant thoracic surgeon Mr Marco Scarci answers your questions about the surgery. 

 

What does minimally invasive surgery (MIS) for lung cancer entail?

There are multiple ways to carry out minimally invasive surgery for lung cancer. Some surgeons choose to operate using camera assisted surgery. During camera assisted surgery, the cut made is marginally smaller than the cut from an open surgery. The operation is guided through the cut, using the camera as a light source.

Some doctors believe that camera assisted surgery is quite old fashioned and believe that it does not permit good access to all areas inside the chest.

 

There is a more common and widespread form of minimally invasive surgery which uses three small incisions and dedicated instruments. However, there is an issue with this technique because having three holes in between ribs at different level in the chest together with the use of a trocar (a rigid plastic tube used to insert the camera) may increase the chances of damaging the intercostal nerve with potential for long term pain.

 

Several surgeons only use one 3cm incision for all procedures, which results in limited pain, scarring and a quicker recovery process.  
 

Are all patients suitable for surgery using this approach?

The vast majority of them are suitable for minimally invasive surgery. The only limitation is that if a cancer is too big it will not come through the ribs, even if in some cases there is a special manoeuvre which allows this to happen safely. 
 

What are the advantages of minimally invasive surgery in this context?

Minimally invasive surgery allows patients to have a significantly reduced hospital stay. Patients also require less morphine- based pain medication, have minimal scarring and are able to return to normal activities more quickly following surgery.

 

Are there any disadvantages or limitations?

Surgery may be limited due to the size of the tumour and whether it involves critical structures such as the spine, oesophagus or the heart. Otherwise, most cancers can be treated safely by keyhole approach in the hand of experience practitioners. 
 

What does the recovery period look like following minimally invasive surgery for lung cancer?

In the majority of cases, patients improve well in about 1-2 weeks and feel completely normal in 2-3 months. Following surgery, they can do regular, every day activities such as walk, drive, get dressed, go up the stairs and socialise but they feel the effects of the operation if they do something strenuous, such as hiking, cycling, running or golfing. Most patients can return to clerical work in a couple of weeks and manual work in about 3-4 weeks. 
 

In many cases of minimally invasive surgery for lung cancer, 25% of patients are able to return home on day 1, 50% on day 2 and the remaining 25% of patients can return home in 3 or more days.

 

The vast majority of patients are capable of resuming oral intake immediately after surgery and usually sit out of bed the day of surgery. 
 

 

 

If you require surgery for lung cancer and would like to book a consultation with Mr Marco Scarci, do not hesitiate to do by visiting his Top Doctors profile today.

By Mr Marco Scarci
Cardiothoracic surgery

Mr Marco Scarci is a highly respected consultant thoracic surgeon based in London. He is renowned for his expertise in keyhole surgery, particularly in the treatment of lung cancer and pneumothorax (collapsed lung). He also specialises in rib fractures, hyperhidrosis (excessive sweating), chest wall deformities and emphysema. He sees private patients at OneWelbeck, the Harley Street Clinic and the Sainsbury Wing, Imperial Private Healthcare.
 
Mr Scarci qualified as a doctor of medicine with honours in 2001 at Italy’s Università degli Studi 'Gabriele d'Annunzio' di Chieti, before pursuing further specialist training in cardiothoracic surgery. He then undertook a clinical fellowship at Basildon and Thurrock University Hospital and a senior clinical fellowship in thoracic surgery at Guy’s and St. Thomas’ NHS Foundation Trust. In addition, he completed an additional six-month thoracic surgery fellowship at the University of Toronto, Canada in 2011 and another in advanced keyhole surgery with McMaster University, Canada. That same year, he was appointed as a consultant thoracic surgeon at Papworth Hospital NHS Foundation Trust. Following this, he went on to work at University College London Hospital, San Gerardo Hospital, Italy and Imperial College NHS Healthcare Trust, where he is currently based. With his wealth of experience and expertise in both surgical and non-surgical treatment for a wide range of conditions, Mr Scarci is regarded as one of the UK’s leading practitioners in the field of thoracic surgery, whose skill and dedication has been recognised with several awards, including an NHS Clinical Excellence award in 2013.
 
Throughout his esteemed career, Mr Scarci has held a number of senior positions. He previously led chest wall database and pleural malignancies working groups for the European Society of Thoracic Surgeons and was also formerly a council member and director of the Society's annual conference, the largest conference in thoracic surgery in the world. He also forms part of several of the National Institute for Health and Care Excellence’s (NICE) working groups. Mr Scarci is also a leading name in medical education and is an honorary clinical senior lecturer at Imperial College London and a senior clinical tutor at the University of Cambridge.
 
Mr Scarci has an extensive background in academic research and has authored over one hundred and thirty publications which appear in leading peer-reviewed journals. With his wealth of expertise, he is a co-speciality chief editor for thoracic surgery in the revered Frontiers in Surgery academic journal and is an associate editor of the Journal of Thoracic Disease and the Journal of Thoracic and Cardiovascular Surgery, the most prestigious in his speciality. He is also the author and editor of four published books on minimally invasive and open thoracic surgery.
 
Mr Scarci regularly presents at key conferences in the field of thoracic surgery. He is an appointed fellow of a number of highly respected professional bodies, including the Royal College of Surgeons of England, the American College of Chest Physicians, the American College of Surgeons and the European Board of Cardiothoracic Surgery. With support from his administrative team, patients can get in contact with Mr Scarci quickly and efficiently. Mr Scarci is dedicated to providing attentive, friendly, and reassuring care for his patients that is tailored to their individual needs in order to improve their quality of life.

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