Last Updated 05/07/2020

Authors:Ray K. Chihara, MD; Samantha D’Annunzio, MD; Loren Harris, MD, FCCP; Allan Pickens, MD, FCCP

About Thoracotomy

Key facts about Thoracotomy
  • A thoracotomy is a surgical procedure in which an incision is made between the ribs to see and reach the lungs or other organs in the chest (also called the thorax).
  • Thoracotomy is typically done on the right or left side of the chest. In rare cases, the surgeon may cut through your breast bone at the front of your chest.
  • Thoracotomy is done to diagnose or treat disease.
  • Thoracotomy enables surgeons to see tissue, take a sample (or biopsy), or remove more tissue as needed.

What to expect

You will be asleep (under general anesthesia) for your thoracotomy. You may have a tube (called an epidural catheter) inserted into your spine at your mid-back before surgery to provide drugs for the pain. Once you’re asleep, you will have a breathing tube placed down your throat. This will let the surgical team fill each lung with air (or inflate it) on its own during the operation.

You will be rolled on your side. Then, the surgeon will make an incision about 6 inches long below the tip of your shoulder blade. Typically, the cut is made between the fifth and sixth ribs. During the surgery, you will have a chest tube inserted on the same side as the thoracotomy. The tube will drain excess fluid or air leaking into your chest and will help your lungs inflate again. This tube will stay in place for a few days.

Once you wake up, you can expect some pain when taking a deep breath. You will be given medications for this pain. Your care team will have you use a device for breathing exercises (called an incentive spirometer) to help prevent pneumonia while you recover. They may also teach you how to wrap (or splint) your chest. This will help you breathe deeply and cough more easily.

Understanding the results

You can have a thoracotomy for many reasons. The results depend on the reason for the procedure. If your doctor needed to remove tissue, it will be sent to the lab for tests. Some tests can take several days to run. Your care team should schedule a follow-up visit within 2 weeks to discuss your results.

What are the risks?

Right after the surgery, you may be at risk for:

  • Infection;
  • Bleeding;
  • Leaking air from your lung; and
  • Pain.

Pain is the most common complication. You may feel pain along your ribs and at the incision site. It will most likely subside over days to weeks. One risk that can occur well after surgery is post-thoracotomy pain syndrome. It happens when nerves are damaged during surgery. Patients with this syndrome feel chest pain for months after the operation. Life-threatening injury from a thoracotomy is rare.