At a glance
A lung resection known as a lobectomy is a surgical procedure that removes one of the lobes (self-contained sections) of the lung, most often to eliminate a cancerous tumour or a severe localised infection.
Each lung is divided into sections called lobes: the right lung has three, the left lung has two. When disease is confined to one lobe, removing that lobe can eliminate the problem while leaving the remaining lobes to take over breathing. After surgery, the body gradually adjusts, and the remaining lung tissue expands to compensate for the lost volume.
Medical Condition
Lobectomy is most commonly used when a disease is confined to one lobe of the lung and the rest of the lung tissue is healthy enough to maintain acceptable breathing after the lobe is removed.
- Non-small-cell lung cancer (NSCLC) at an early to intermediate stage, where the tumour has not spread beyond the lobe.
- Carcinoid tumours (slow-growing tumours that arise from hormone-producing cells in the lung).
- Bronchiectasis (permanent widening and scarring of the airways) that is severe and limited to one lobe.
- A lung abscess (a pocket of infection) that does not respond to antibiotics.
- Severe, recurrent fungal infections such as aspergilloma (a fungal ball growing in a lung cavity).
- Tuberculosis (TB) complications, such as destroyed lung tissue that keeps causing bleeding or infection.
- Congenital malformations (structural abnormalities present from birth) limited to one lobe.
Lobectomy is generally not suitable when overall lung function is already significantly reduced, when cancer has spread to both lungs or distant organs, when the patient has severe heart disease that makes general anaesthesia too risky, or when the patient's general health would not support recovery from major chest surgery. Your doctor will review your breathing tests, imaging scans, and other health factors before deciding.
Risks & Complications
Lobectomy is major surgery and carries real risks; your surgical team will weigh these against the risks of leaving the disease untreated.
- Air leak: air escaping from the cut edge of the remaining lung into the chest cavity, the most common complication, usually resolving with a chest drain left in place for a few extra days.
- Pneumonia (lung infection) in the remaining lung tissue, particularly in patients who smoke or have reduced lung function.
- Atrial fibrillation (an irregular heart rhythm) that can appear in the first few days after chest surgery and usually settles with medication.
- Bleeding inside the chest that may require a return to the operating theatre.
- Prolonged air leak lasting more than a week, sometimes needing additional procedures.
- Wound infection at the incision site or, more rarely, infection inside the chest cavity.
- Deep vein thrombosis (a blood clot forming in a leg vein) or pulmonary embolism (a clot travelling to the lungs), both of which are managed with blood thinners.
- Reduced breathing capacity after surgery, which is expected but can be more significant if lung function was already limited.
- Rare but serious risks include stroke, heart attack, and respiratory failure requiring temporary ventilator support.
- Death is an uncommon but recognised risk of any major lung surgery, and your team will assess your individual risk level before proceeding.
Preparation & Procedure
Preparation begins days or weeks before surgery. Patients who smoke are strongly advised to stop as early as possible, because smoking slows healing and raises the risk of lung complications after chest surgery. Alcohol intake is usually reduced in the weeks before the operation. Blood thinners, aspirin, and certain anti-inflammatory medications are paused according to your doctor's guidance, as they increase bleeding risk.
You will stop eating and drinking, including water, for several hours before surgery. The exact fasting window is set by your anaesthesia team and varies by hospital, but six hours without food and two hours without clear liquids is a common standard.
Before the operation, you will undergo a set of tests to confirm you can safely tolerate the procedure. These typically include a CT scan (computed tomography, a detailed X-ray that maps the lobe to be removed), pulmonary function tests (breathing tests that measure how much air your lungs can move), an echocardiogram (an ultrasound of the heart) or ECG (electrocardiogram, a recording of the heart's electrical activity), blood tests, and sometimes a PET scan (positron emission tomography, a scan that shows metabolically active tissue and helps stage cancer).
On the day of surgery, the steps generally follow this order:
- You change into a hospital gown and a nurse confirms your identity, allergies, and medication list.
- An intravenous (IV) line is placed in your arm for fluids and medications.
- The anaesthesia team places a breathing tube and a special double-lumen tube (a tube that allows one lung to be temporarily deflated during surgery) after you are asleep.
- The surgeon makes incisions either along the side of the chest (thoracotomy, open surgery) or through several small cuts using a camera and instruments (VATS, video-assisted thoracoscopic surgery). Your surgical team will have discussed which approach fits your case.
- The targeted lobe is identified, its blood vessels and airway are carefully tied off and divided, and the lobe is removed.
- One or two chest drains (thin tubes) are placed to let air and fluid escape from the chest cavity while the lung re-expands.
- The incisions are closed and you are moved to a recovery area where anaesthesia wears off under close monitoring.
Aftercare
Recovery from lobectomy takes place in stages: first in hospital, then at home over several weeks. Most patients spend the first day or two in a high-dependency or intensive care unit (ICU) where breathing, heart rhythm, and pain are closely monitored, before moving to a general surgical ward.
- Chest drains remain in place until air leaks stop and fluid drainage is minimal, usually within two to five days, though this varies.
- Physiotherapists guide breathing exercises and early walking starting the day after surgery to prevent pneumonia and blood clots.
- Pain is managed with a combination of approaches, which may include an epidural (a pain-relieving catheter near the spine), nerve blocks, and oral pain medication.
- Hospital stays typically range from three to seven days for VATS and somewhat longer for open thoracotomy, though individual recovery varies widely.
- After discharge, heavy lifting, strenuous activity, and driving are restricted for several weeks. Your surgical team will set specific timelines.
- The surgical wound or port sites are kept clean and dry. Any signs of redness, swelling, warmth, or discharge should be reported to your care team promptly.
- A follow-up appointment is usually scheduled within two to four weeks of discharge to review wound healing, repeat a chest X-ray, and discuss pathology results if the surgery was for cancer.
- Patients treated for lung cancer will usually enter an oncology (cancer specialist) follow-up programme that includes regular CT scans to watch for recurrence.
- Pulmonary rehabilitation (a supervised programme of breathing exercises and gradual fitness training) is recommended for many patients and can significantly improve long-term lung capacity.
- Smoking cessation support is offered at most centres and is strongly linked to better recovery outcomes.
Cost & What Determines It
The cost of a lobectomy varies widely from one patient to the next and from one country to the next, because so many factors specific to chest surgery affect the final bill.
- Surgical approach: VATS (minimally invasive, using small incisions and a camera) generally involves a shorter hospital stay and lower costs than open thoracotomy, but not all cases are suitable for VATS.
- Stage and complexity of disease: a small, early-stage tumour in an accessible lobe is technically simpler than a tumour near major blood vessels or a lung damaged by chronic infection.
- Hospital class and country: a university hospital or internationally accredited centre charges more than a standard public hospital, and prices differ substantially between countries.
- Length of stay: chest drain complications, air leaks, or infections that extend the hospital admission add directly to the cost.
- ICU or high-dependency unit time: patients who need more intensive post-operative monitoring incur higher daily charges.
- Anaesthesia fees: thoracic surgery requires a specialised anaesthesia team and equipment including a double-lumen breathing tube and one-lung ventilation management.
- Pathology and staging tests: if the lobe is removed for suspected cancer, laboratory analysis of the tissue and additional lymph node (small immune gland) testing add to the total.
- Imaging before and after surgery: pre-operative CT, PET scan, and post-operative chest X-rays are each billed separately in many hospitals.
- Oncology treatment after surgery: if chemotherapy or radiotherapy is recommended following the operation, those costs are separate from the surgical episode.
- Rehabilitation: pulmonary rehabilitation sessions, if provided outside the base package, are billed additionally.
Hospital packages for lobectomy typically cover the surgeon's fee, anaesthesia, operating theatre use, standard nursing care, and the chest drain equipment used during the admission. Items frequently billed separately include pre-admission specialist consultations, pathology and laboratory fees, imaging studies, medications dispensed during the stay, any ICU upgrade, and follow-up outpatient visits after discharge.
BPJS Kesehatan does not cover treatment received outside Indonesia, and most Indonesian private health insurance policies also exclude overseas care. Patients who travel abroad for a lobectomy generally pay out of pocket or through an international private insurance policy that explicitly covers overseas hospital treatment. Before travelling, ask the hospital for a written cost estimate that itemises what is and is not included, so there are no unexpected charges on discharge.
Frequently Asked Questions
How long does a lobectomy surgery take?
A lobectomy usually takes between two and five hours, depending on which lobe is removed and whether the surgeon uses open surgery or a minimally invasive approach called VATS (video-assisted thoracoscopic surgery, where small cuts replace one large opening). Your surgical team will give you a more specific estimate once your scans and medical history have been reviewed.
How much does a lobectomy cost?
The cost varies based on several factors specific to this procedure, including whether open surgery or VATS is used, how many days you spend in hospital (often including time in the ICU), the complexity of your case such as tumor size and location, and the class of ward you choose. Requesting a written estimate directly from the hospital is the most reliable way to get a figure that reflects your actual situation.
How long is the recovery after lung removal surgery?
Most people spend five to ten days in hospital after a lobectomy, and return to light daily activities within four to six weeks at home. Full recovery, including regaining comfortable breathing capacity, often takes two to three months. Your doctor will track your progress through follow-up appointments and adjust your recovery plan as your remaining lung tissue adapts.
What warning signs should I watch for after a lobectomy?
Contact your medical team promptly if you develop sudden shortness of breath, chest pain, a high fever, or notice fluid or pus leaking from your wound. Coughing up blood beyond a small amount, or feeling your heart beating very fast or irregularly, also warrants immediate attention. These signs do not always mean something serious has gone wrong, but a doctor needs to assess them quickly to rule out complications such as infection or an air leak in the chest.
This page is general information, not a substitute for medical advice. Every case is different. Your doctor decides what is right for you.
