ALERT CONTENT PLACEHOLDER

  • About chest wall resection surgery
  • Before my surgery
  • Preparing for my surgery
  • After my surgery
  • Back at home
  • Follow-up appointments
  • My contacts
About chest wall resection surgery

A chest wall resection is done to remove part of a rib(s). Your surgeon will tell you where and how big (8-25 cm or 2.5-10 in) your incision will be.

Before my chest wall resection

Pre-Admission Visit

You will have an appointment at the Pre-Admission Clinic within two weeks before your operation. This visit is very important to assess your health and help you prepare for your operation and recovery. Plan for your visit to take 2–5 hours. On the day of your pre-admission visit, take your medications and eat as usual, unless you were given other instructions.

Pre-Admission Clinic at Toronto General Hospital
Eaton Building – Ground Floor, Room 400

What should I bring to my pre-admission appointment?

  • Your health card (OHIP card). If you do not have an OHIP card, please bring another form of government-issued photo ID, such as a driver's license or passport.
  • Any other insurance cards. You will need the policy number of your extended health insurance, if you have any.
  • Your spouse/partner, a trusted friend or family member (to offer you support and be a second set of ears).
  • All the medications you take in their original containers. This includes prescription medications, over-the-counter medicines, vitamins, supplements and herbal or natural products.
  • A copy of your power of attorney for personal care and/or advanced directives.
  • A list of any questions that you may have about the operation and recovery.
  • The name or phone number of your pharmacy, as well as any medical specialists that you have seen in the past 3 years.
  • If you have had a cardiac stress test, echocardiogram and/or a pulmonary function test in the past 3 years, it would be helpful to bring a copy of the final report with you to this appointment.

What happens during my pre-admission visit?

  • You will have blood tests and routine skin swabs. The swabs are taken from your nose and other areas of your body to check for germs that can cause infections.
  • You may also need an electrocardiogram (ECG) to check your heart and a chest x-ray to check your lungs.
  • You will meet many health care providers during your pre-admission visit. Please feel free to ask them any questions that you may have.
  • A pre-admission nurse will review your health history and give you information to prepare you for your operation, including directions for cleaning your skin, eating before your operation, taking your medications and pain management.
  • A pharmacist will review your medications.

Depending on your needs, you may also meet:

  • An anesthetist who will review your health history, discuss your anesthetic plan and pain relief after your operation.
  • A member of the medicine team, if you have other complex health problems.
Preparing for my chest wall resection

The night before your surgery

  1. Do not eat or drink after midnight on the night before your surgery.
  2. If you smoke, do not do so for 24 hours before your operation.
  3. Do not drink alcohol for 24 hours before your operation.
  4. Remove all nail polish and body piercings.
  5. You must have a shower with soap and water to clean your skin the night before and the morning of your surgery to reduce the chance of infection after your operation.

Stop smoking before your surgery: learn how smoking and tobacco can affect your recovery after surgery, and how quitting can improve your health.

WHAT SHOULD I DO THE DAY OF MY SURGERY?

Arrive 2 hours before your scheduled operation time.

Surgical Admission Unit (SAU) at Toronto General Hospital
Peter Munk Building – 2nd Floor
All hospital entrances are open by 6:00 am. However, Elizabeth St. and University Ave. are easiest to access.

After my chest wall resection

What can I expect to have on my body?

You will be attached to some or all of these machines and tubes:

Incisions, tubes or drainsWhat to expect
Incisions: You may have an incision on your side (thoracotomy), down the middle of your chest (sternotomy), under one of your breasts (hemi-clamshell), or under both of your breasts right across your chest (clamshell).
stitches orstaples illustration Stitches or staples: Your surgeon usually uses dissolvable stitches to close your incisions that will go away on their own.
Dressings (bandages): You will have dressings covering your incisions.
chest tube illustration Chest tubes: You will have 1 to 2 chest tubes coming out of the side of your chest. They remove air and fluid from the inside of your chest area.
jp drain illustration JP drain (Jackson Pratt drain): This small tube helps drain any extra fluid. It is removed when you no longer need it.
heart monitor illustration Heart monitor: You will be on a heart monitor while you are in the Step Down Unit.
urinary catheter illustration Bladder catheter: You will have a tube draining your bladder overnight.
IV illustration Intravenous (IV): You have at least one IV in your arm and another one in the side of your neck.
arterial line illustration Arterial line: This line goes into an artery in your wrist during surgery. It looks like an IV but we use it to check your blood pressure and to get blood samples.
Oxigen illustration Oxygen: At first, you will have an oxygen mask over your nose and mouth, then you may get oxygen through your nostrils (nasal prongs).

HOW CAN I MANAGE MY PAIN?

We will work with you to manage your pain. We can give you pain medicine in different ways:

Pain relief methodHow it works
epidural illustration Epidural: With an epidural, a doctor puts a small tube in your back. They usually do this right before your surgery. The tube is left in place to give you pain medicine after your surgery. It's attached to a pump, which gives you the medicines.
extrapleural illustration Extrapleural catheter: This can be used to manage pain in patients who had a thoracotomy.
pca illustration Intravenous (IV) Patient Controlled Analgesic (PCA): A PCA pump is connected to your IV that gives you pain medicine through your IV when you push the button.
IV medicine illustration Intravenous (IV) medicine: You get your pain medicine through an IV.
pills illustration Medicine by mouth: You may get your pain medicine in tablets that you swallow. This will happen once you are drinking fluids.
Back at home

You will continue to recover when you return home.

ActivityHow to manage at home
eating and drinking icon
  • Your appetite should return to normal within a few weeks. Make sure you drink fluids.
bathroom icon
  • Constipation is common when you take pain medicine.
  • Drink plenty of fluids (a minimum of 6 cups per day unless your doctor or dietitian tells you otherwise).
medication icon
  • It is important to take pain medicine as needed.
medication icon
  • The incisions will not need to be covered unless your clothes are rubbing on them.
  • Do not put lotions or creams on the incisions until they are completely healed.
  • The numbness around your incisions is normal.
bathing icon
  • You can shower every day once you get home. Use a mild soap. Pat the incisions dry with a towel.
working icon
  • You will be off work for at least 4 to 6 weeks. Check with your surgeon when it is safe for you to return to work.
driving icon
  • You should not drive until you are off the pain medicine.
  • You must have full movement of your arm and shoulder before you drive. This is usually 2 to 3 weeks after surgery.
weight icon
  • No heavy lifting, carrying, pushing, or pulling for 4 to 6 weeks.
  • You may lift up to 4.5 kg (10 pounds).
sex icon
  • You may have sex again after your surgery. Avoid positions that cause strain on your incision.
walking icon
  • You may gradually increase your activity. Walk at least once every day as you can tolerate it.
  • You may swim after 6 to 8 weeks, golf after 3 to 4 weeks.
  • Jogging, tennis, aerobics, and racquetball should not be done for 4 to 6 weeks.
  • Please talk to your surgeon about skydiving and scuba diving.
walking icon
  • Please check with your surgeon about travelling
  • We usually recommend that you do not travel by air for 2 to 3 weeks.
Follow-up appointments

Where and when

Four to six weeks after your surgery, you will have an appointment at your surgeon's office and the Medical Imaging Department (for your chest x-ray).

My contacts

Who do I call with general post-operative questions?

Call your surgeon's office:

Dr. M. Cypel
Phone: 416 340 5156

Dr. G. Darling
Phone: 416 340 3121

Dr. M. de Perrot
Phone: 416 340 5549

Dr. L. Donahoe
Phone: 416 340 4800 ext. 6529

Dr. S. Keshavjee
Phone: 416 340 4010

Dr. A. Pierre
Phone: 416 340 5354

Dr. T. Waddell
Phone: 416 340 3432

Dr. K. Yasufuku
Phone: 416 340 4290

Dr. J. Yeung
Phone: 416 340 4800 ext. 6529

Who do I call if I experience complications

Call 911 to take you to the nearest Emergency Department if you:

  • Have chest pain, tightness, or significant shortness of breath.
  • Have "the worst headache of your life" that does not go away by taking pain medication.

Call your surgeon's office if you notice the following symptoms:

  • Your incision is red, warm to the touch or has discharge or a bad smelling odour.
  • You have a fever (a temperature of 38°C or higher for 2 days).
  • You have pain that is not relieved by your pain medication.
  • You have a sharp pain or tenderness in the back of your calf or numbness and tingling in your foot.