EP 3: My Robotic Lobectomy Surgery: What I Wish I Knew

If you’ve been told you need lung surgery—or are researching robotic lobectomy—this episode is for you.

Host Tina Powell, a Stage 4 non-small cell lung cancer survivor (EGFR mutation), shares her personal experience of undergoing a robotic lobectomy at NYU Langone. From pre-surgery testing to recovery, she walks through every stage of the journey from a patient’s perspective—the kind of information she wishes existed when she searched YouTube three years ago.

This honest, step-by-step account reveals what to expect before, during, and after surgery, how to manage fear and recovery, and why biomarker testing was a critical turning point in her cancer care.

You’ll learn:

• What makes someone eligible for robotic lobectomy surgery
• The tests, scans, and health factors doctors consider before approval
• What happens in the operating room and during the hospital stay
• How to manage chest tubes, incisions, and nerve pain
• The importance of breathing exercises, walking, and gradual recovery
• Why biomarker testing after surgery can save your life

Chapters

• 0:17 Why I Made This Video
• 1:42 What Is a Robotic Lobectomy?
• 2:10 Am I Eligible? Understanding the Criteria
• 2:59 Stage, Health, and Testing Requirements
• 4:27 Lung Function and Spirometry Testing
• 5:22 Location of the Tumor Matters
• 5:51 The Role of Medical Insurance
• 6:45 Surgery Day: My Experience at NYU Langone
• 8:54 Recovery in the Hospital
• 9:35 The Chest Tube: What to Expect
• 10:33 Walking, Breathing, and Healing
• 12:25 Being Discharged and Going Home
• 13:28 First Look at My Incisions
• 14:00 Pain Management Without Opioids
• 15:11 Understanding Nerve Pain
• 15:44 Products That Helped: SalonPas & Gabapentin
• 16:18 Rebuilding Lung Function
• 17:10 Walking as Medicine
• 17:34 Take It Slow: Healing Takes Time
• 18:18 When Surgery Isn’t the End of the Story
• 18:58 The Power of Biomarker Testing
• 20:39 What I Learned and What I’d Tell Others
• 21:33 Nearly Three Years Later — My Results and Reflections
• 22:00 Closing Thoughts: Gratitude, Strength, and Hope

Transcript

0:01

I wish there was a video like this before I had my robotic lobectomy surgery. When I searched YouTube back then, all I could find were scientific videos about the surgery itself, usually recorded by a cancer hospital or a surgeon, even some that were way too graphic to watch. But nothing, nothing was ever recorded from the patient's perspective about what to expect, how was I going to feel afterwards, and what, if anything, was a long term consequence of having the surgery. So in this video, I'm going to share my robotic lobectomy journey nearly three years later, as well as things that I wish I had known before, during, and after my surgery and how it went. Hi, I'm Tina Powell, stage four lung cancer survivor, thriver and patient, and your host for lung Cancer Strong. Welcome to my channel. I'm really, really excited and grateful that you're here for this important episode. I get asked so many questions about robotic lobectomy before we dive in. If you're watching me on YouTube, I will be sharing actual pictures of my robotic lobectomy at different stages so that you can see the progression. Not to gross you out, I promise. They're not gross. But the good news is today, nearly three years later, and if you watch until the end, I would definitely. I'm going to share that picture of what it looks like today. You can barely tell that I even had the surgery, which is an awesome, awesome outcome. And remember, everybody, ladies and gentlemen and friends, this video is for educational purposes and deals with my own lung cancer journey, my perspective. So your outcome and your experience may be different. Okay, let's go. Let's get right into it. Robotic lobectomy. What is it? A robotic lobectomy is a minimally invasive surgery and procedure used to remove a lobe of the lung. It's performed by a thoracic surgeon. Remember, friends, we have five lobes of the lung. Three on the right side and two on the left side. Now, just. Just because the surgery exists doesn't mean that you're a candidate for the surgery, okay? Eligibility for a robotic lobectomy is very strict, and this was very true for me and was determined by many factors. So let's understand what those factors are. Number one is your stage. My stage at the time of my robotic lobectomy was stage 2B. This initial stage was determined by a bronchoscopy, and it was a medical procedure that allowed a doctor to examine the inside of the airways and the lungs using a flexible tube called a bronchoscope. That procedure is performed by a pulmonologist under general anesthesia. Right. So you are completely out for that procedure. In my case, I had a 2.6 centimeter tumor in my right lobe, upper lobe, contained to one side, contained to just the right side. But I did have cancerous lymph nodes. So again, before your robotic lobectomy procedure, a pulmonologist is going to go in and determine the location and do an environmental scan of both lungs to determine whether or not that you are eligible for that surgery. So number two, overall health. My health at the time of my surgery and still is, is excellent. I'm a non smoker, I'm not a drug user. At the time of my surgery, I was going to Orange theory. I was doing pelotons, I was riding horses. However, that's not enough to see if you can withstand the surgery. They also did a pulmonary function spirometric. I don't know if I'm pronouncing that correct. Friend's spirometry test. There it is. Whoop, there it is. To measure how well my lungs worked, that test was performed by a respiratory therapist who put me in this telephone booth box, like the kind that you see here. And basically they had me breathe into their machines in various sequences. It wasn't painful, but I remember having to take some very deep, deep breaths, holding my breath and breathing out for a very, very long time. So again, overall health, that's another factor that goes into your eligibility for a robotic lobectomy. Next, in order to qualify for robotic lobectomy, they gave me other tests. They gave me a CT scan of the chest to take a look over there. They gave me a brain MRI to make sure that the cancer hadn't spread to my brain, a thoracic EKG to look at my. And all of that, and blood work, also known as labs. So there was quite a, quite a rigor of tests before you even go to the robotic lobectomy operating table. Okay, Next was the location of my tumor. As I said before, my tumor was in my upper right lung and it measured 2.6 centimeters. And this was confirmed by that bronchoscopy. Okay. So the location of your tumor will. Affect your eligibility for robotic lobectomy. So if your tumor is not in a great place, then unfortunately you can't have the surgery. Okay. Lastly, and something that I think is. Really important, friends, and that is medical insurance. My medical insurance did cover most of. The cost of the surgery. However, there was some portion of that, that being out of pocket, that I was responsible for. I don't remember how much money was, but basically when you have a tumor growing in your right lung. You don't worry about out of pocket expenses. They weren't astronomical. They were there. So I do want to make sure that you go through insurance and you know that your procedure is being covered by insurance. Because a robotic lobectomy is very expensive. It is coupled with hospital, hospitalization, stay, loss of work. You have to remember so you know, all of those things. So I wound up did qualifying for the surgery. I had the surgery. I had it February 13th of 2024. 23. Sorry. February 13th, 2023. It was performed at NYU Langone. My thoracic surgeon, who was excellent is Dr. Amy Kent, my oncologist at the time. Also excellent was Joshua Sabari. Basically, NYU did a great, great job. My surgery was perform in the morning. I remember being, you know, literally walking into the OR and immediately seeing bright lights, hearing music, like, I think it was classical music, and then seeing computers and electronics on my right side. And it blew me away. It was wild. It was futuristic. It felt like I was in a movie. So again, very bright and very cold. Ors, for whatever reason, are super, super cold. So as soon I walk in, I see a bunch of people. And the anesthesiologist had me lay down on the table. The first thing that he did was he inserted the iv. And I remember his accent. It sounded very James Bondish. I swear, I felt like I was in a movie. I don't remember anything other than, like, pretty soon after he inserted the iv, they. They put me out. So I was, you know, you are completely out for this surgery. It takes about anywhere from two to four hours. Mine was four hours long. Not only did they remove the 2.6 centimeter tumor, but they also involved my cancer, involved the lymph nodes as well, too. So they were able to extract those lymph nodes as many as they could as they could extract at the time. So, you know, once I was out of the or, they move you into, like, a recovery room. And I don't remember the recovery room. I remember my right, regular room because it was Valentine's Day the following day. And my room overlooked Manhattan and New York, which is my favorite city, if you guys know. Okay, so let me take you then to the following day. Okay. We talked about eligibility. We talked about my. My surgery. Okay, now fast forward to recovery, what it was like. So the following day, I became very aware that there was a chest tube made out of plastic coming out of my right side. And I could see the drainage, and I could also see the machine this tube, and you could see it on the picture here. Basically, this is the machine that helps to remove air and fluid, preventing your lung from collapsing. It's probably, probably one of the most important, if not the most important, of. Robotic lobectomy after your surgery. And my thoracic surgeon even spoke about the chest tube, she's like, hey, Tina. You know, you're going to have this. Chest tube, and if your lungs don't drain properly, you're going to need to go home with it. Right? So some people that have a robotic lobectomy procedure will wind up going home with having the chest tube and a basically machine that you see right here. Okay, the good news is for me that my lung healed properly and they removed the chest tube right before I went home. But now here's the thing. The removal of the chest tube absolutely petrified me, you guys. I was scared to death about them removing the chest tube because, like, you know, you could feel it. And it's inside, and I'll show you the scars where, where that was. But I let the nurses know that I was scared about that chest tube removal. And because of that, like, I think that they were a little bit more gentle with me, and they removed it very quickly. So, you know, if you're scared about that, which I was a big fraidy cat about it, you know, mention that, mention that. Okay, hey, you know, how is this going to go? Like, talk. Make them talk you through it. Don't just have them come in and, okay, we're here to remove the chest tube. Know what that is like. So in my case, that was. They did it very quickly, and I was relieved. A big part of your recovery is what you need to do from an exercise point of view to speed up your progress and to help your lungs to heal and to prevent them from collapsing. Number one, the first thing is walking. I walked every chance I could get. As soon as you are, like, you know, awake and aware, you need to get walking every single day. Now, walking wasn't painful, but I did, as you can see here, have to carry the chest tube machine with me and have some escort. So, in other words, I couldn't walk alone, right? I couldn't walk alone while I was in the hospital. But that walking is essential, and you need to do it as many times per day. Number two is that I needed to exercise my breathing using a spirometer. That is this device that you see here. And I still actually have my spirometer from. From years back. Right. I did this throughout the day and this was the most important thing. I think I got up to maybe halfway right after the surgery. But within weeks, I was doing these exercises daily. And today my lung function is back to normal. So again, they're going to look for your ability to walk, to pass gas, and to make sure that your spirometer readings are of a certain level. So what they did was they released me in about three days. I spent two nights in the hospital. And again, it was, I had a very nice room. NYU Langone gave me a beautiful view of the city and really some of the nicest nurses and people. I remember. Even the janitor was nice, you guys. He was so, like, pleasant. So I really enjoyed that state. Okay, but next is, is coming home, right? What does that look like? Okay, first is they want you to remove and clean the bandages. So there wasn't a huge amount of blood or anything leaking. But I was very curious to see what those incisions look like, because at the hospital I did, I couldn't get, I couldn't see it. Like everything was all wrapped up. So you don't remove those bandages until you get home. How I described it. And again, you know, not to be gross or anything, but I want you to see how, what to expect. I described it as like a shark attack. A shark attack. I, I joked that I was going to go to the beach in Bikini and said, yeah, you know, it was the shark or me, but, you know, I, I, I beat that shark. Anyway, as you can see, the incisions. What's unique about the incisions from a robotic lobectomy is that they go from the front to the back. So it's like, you know, it makes sleeping kind of complicated. In my case, everything was on my right side, so I used a whole bunch of pillows to sleep upright on my left side. And getting out of bed was really, really hard. I remember that first few weeks, I needed Mark's help to get out of bed almost every single time. So the incision sites are really, really sore. For medications, I was not on any serious medications. I basically took Tylenol and gabapentin. I did not want to be on any opioid. Opioid drugs. That was just me. I. Tylenol and gabapentin work great. So you, you've all heard of Tylenol, right? So make sure you have a full bottle. Go to Costco or BJ's and get a full bottle of Tylenol extra shrink, because you're going to need that. The next medication, which was not an over the count medic prescribed by my oncologist and that is gabapentin. Gabapentin is basically used to treat nerve pain. Now my thoracic surgeon warned me about nerve pain, which is a byproduct of surgery. So I can't really. It's part numbness and it's part tingling. Basically how my thoracic surgeon labeled it was, she explained it that the nerves get inflamed and get angry. I love that word, angry. That's definitely what happened. And no matter what, it's just what happens when they kind of break through the tissue. So it's nothing that a thoracic surgeon can prevent. Any time that you have any surgery done there, the nerves are going to get inflamed and they are going to test you for that. I used an amazing over the counter product called Salon Pause. S A L O N P A S these were a lifesaver, an absolute lifesaver. And I carried them with me everywhere. So you can order them on Amazon, you could find them at cvs. Just get those in your stash before you have the surgery. I use them for months, carry them everywhere. They were a huge relief. Basically they stick on and they provide some like, almost like a cooling effect. They were great. Now, in terms of my recovery and breathing, it took me many, many weeks for my lung capacity to go back to normal. I was so afraid that after a. Robotic lobectomy, hearing going to remove part of my, my upper lobe of my. Right lung that I was going to. Be out of breath. I wasn't out of breath. I had a slight cough. Right. I had that. And that lasted for I would say maybe like a month and a half. Which was perfectly normal. So I had a slight cough and then it took me, I did those, those breathing exercises as much as I could to get my breathing back to 100% capacity on the spirometer. But I did do daily walking. That is essential. You want to eliminate the risk of pneumonia. You need to get your lungs functioning and you need to walk. I remember my mother grabbing my arm. And walking here and we just walked very, very slow. But that is an essential part of your recovery. Next is that you don't want to. Be driving in a car in those. Initial weeks following your surgery. God forbid that you get into an accident. You really need to guard your health and safeguard yourself. So don't put yourself in any situations that could be harmful to your health. Take it slow, give yourself the grace that you'll need to heal and I. Promise you'll heal well. If you do the breathing exercises, you get plenty of rest and sleep and. You do walking every single day. Robotic. Now three years later Overall I am so glad I had the robotic lobectomy surgery. But back then I was stage 2B and unfortunately it did not clear me of lung cancer. Like I said in my first episode, if you watch my personal story, go. Back and and and you can either listen to that on any of the. Podcast platforms or you can watch here on YouTube. Today I am stage four. Initially I was told that my lung cancer was just a blip and unfortunately that was far from the truth. Just because you have a robotic lobectomy procedure does not guarantee that you will not have a that you will not have a resurgence. This is not to scare you, everybody friends is not to scare you. But it's here to make you hyper aware. With that said, even though that I'm. Stage four today there was a very very very important outcome of the robotic lobectomy procedure and that is the genetic testing, also known as biomark, biomarker testing from my solid tumor. So basically when they took that tumor out, they ran a series of tests in order to determine if I had a genetic mutation. The answer to that question is yes. I was diagnosed with EGFR EXON21L8.58R and because my oncologist and my medical team had that information, I was put on surveillance scans every three months, three rounds of chemo consisting of permetrexate and cisplatin and four months later a targeted therapy known that it took by mouth known as Tagrisso OC mer NITIB is the scientific name that was all done to treat and address my particular form of cancer. So again, a great outcome of a robotic lobectomy procedure is doing the genetic or the biomarker testing on your solid tune tumor. You as a patient must, must get that information because it is essential. Okay, so to sum it all up for you and I really appreciate you you listening to the end. For those of you who qualify for robotic lobectomy procedure, it's minimally invasive procedure. Can compare it to the old school. Open lobectomy where they would literally like open your chest. Definitely deal with a well qualified and proven thoracic surgeon and cancer center and don't be afraid to ask questions. So where you get treated absolutely matters. And even if you're not located near a major metropolitan hospital hospital, you can still go there to have your surgery. So please make sure that you're having that robotic lobectomy procedure from a well qualified thoracic surgeon who's done the procedure many, many, many, many, many, many times, as well as a cancer center that's going to support your full recovery. Okay. Nearly three years later, what I can tell you is I feel great. Even my lung on my right side side has expanded slightly. I walk every day and when they do the finger oxygen test, I have a 99 and 100% oxygen. So it has been a phenomenal journey. I'm really, really glad that I did it and I hope that this information helps you the way that I was looking for information almost three years ago. If you have any specific questions or want to know know anything further, you know, friends, that you could always reach me at Tina at lungcancerstrong. Com and in the meantime, I wish you good luck and lots of love. Take care. We'll talk to you soon and see you on the next episode.