The pleura represents two layers of tissue surrounding both the lung and lining the chest cavity. Between these two layers is the pleural space, which contains a lubricating liquid that helps facilitate breathing. Pleural Surgeries, Pleurectomy or Pleural Bi-Section, and is the removal of either the entire outer layer of the pleura or a portion of it respectively. These procedures usually take about an hour and a half.

These procedures are usually performed as a result of pleural effusion (excess fluid within the pleural cavity), cancer within the pleura (mesothelioma), or sometimes due to extensive scarring or traumas that make it necessary to remove a certain portion of the pleura.  

This is major surgery, and as with every major surgery there are risks. Some of the risks involved in a pleural surgery are bleeding, leakage, infection, increased incidence of blood clots to the lung, heart attack and sometimes death. 

The operation carries with it moderate pain which is controlled even before the surgery begins through a variety of methods. You may be given an Intravenous (I.V.) to control the pain, or an epidural which injects pain medication directly into the spine. Many of the pain reduction procedures are started prior to surgery to minimize the pain immediately after surgery. 

Before Surgery:

As with any major surgery, there are pre-operative tests that must be taken in order to ensure the patient is ready for surgery. These tests make certain that your physician knows as much about your condition as possible which ensures the procedure will be performed as safely as possible. Some of these tests may include: (see the Diagnostic Test section for more details)

• Blood Work
• Bone Scan
• Cardiac Assessment
• CT Scan
• Pulmonary Functions Test
• Thoracic Surgery Lung School

We ask that your Family Doctor fill in your Pre-Operative History & Physical Exam Record (found in your surgical package, form #3) and that it be returned to the surgical package envelope upon completion. Please notify our office or the admitting nurse upon arrival to surgery of any changes in your health after your Pre-Op History and Physical Exam were finalized.  

You MUST NOT EAT OR DRINK anything after midnight the night before your surgery, only clear fluids (such as clear tea, black coffee, apple juice, ginger ale, Jell-O) may be consumed up to 4 hours before your admission time. Morning pills can be taken with a very small sip of water up until two hours before your admission time (NO milk, NO orange juice), after this time no fluids are allowed (not even water). Please be aware that this includes gum, candy and mints.

Day of Surgery:

Take your usual medication the morning of your surgery with a SIP of water unless instructed not to by your doctor. Please take a shower or bath and remove all make-up and nail polish and tie your hair back if it is long. Wear comfortable clothing which will be easy to put on after your surgery and wear your hearing aid and glasses instead of contacts.

Please leave all cash, valuables and jewelry at home, since there are no lockers and the hospital assumes no responsibility for patient valuables. Also, please leave cell phones and electronic devices at home, as they CAN NOT be used in the hospital.

Please bring with you:

• Your surgical package with all the papers completed inside
• Your Ontario Health Card or a list of all your current medications (including herbal remedies). Please include dosage and times taken per day.
• If you are currently taking any puffers, or nitroglycerine (pills or spray), please bring them as you may be asked to use them just before your operation.
• We ask that you bring a tote bag with your clean bathrobe and slippers and since you will be staying overnight bring your toiletries. Anything else you might require during your hospital stay should be brought by family members after your operation.

Upon arrival to the hospital please proceed to Same-Day Admitting on the East end of the 2nd Floor of Southlake Regional Health Centre. After registering, your family and friends will be asked to wait in the Surgical Admissions Waiting room on the 2nd Floor during your procedure.

After Surgery:

Please remember that every patient’s recovery and recovery time is different depending on the individual and we can only provide approximate time frames and expectations.

You will wake up from the anesthesia in the Post-Anesthetic Care Unit (P.A.C.U., aka. Recovery Room), here you will spend several hours under close surveillance while recovering from surgery. You may wake up with a breathing tube down your throat; this tube will be removed soon after you are awake when you can breathe on your own. After the recovery room you will proceed up to the Surgical In-patient unit on the 5th Floor or to the Intensive Care Unit (ICU).

You can expect to be in the hospital from anywhere between 1 to 4 days after surgery, where your heart, breathing and drainage will be monitored very closely by the nurses and hospital staff. Bandages will cover the sites where the chest tube and incisions were; these are to be kept dry and kept in place for several days after returning home. After several days, you may wash the wounds with water and a mild soap (no bathing) and re-cover with dry gauze if there is any discharge. You must have a friend or relative present to take you home in order to be discharged from the hospital.

Please do not hesitate to call our office if you are experiencing any excessive bleeding, wound discharge, pain, fever, difficulty breathing, vomiting, if your prescription runs out or if you have any questions at all. If you are experiencing any of these problems and are not able to speak with someone in our office (ie. after business hours or on the weekend) and the problem is severe; please visit your local emergency room.

You will have a post-surgery follow-up appointment booked with Dr. Toth, Dr. Privitera, or Dr. Kavanagh in 4-6 weeks after your surgery. During this appointment you will discuss the operation and the final pathology results.