wedge resection
Meaning of wedge resection: Removal of a triangular block of tissue with the abnormal area at its center, taking as little healthy tissue as safety allows.
Definition of wedge resection
A wedge resection is an operation that removes a triangular or pie-shaped piece of tissue containing an abnormal area, together with a rim of normal tissue around it. It cuts across the natural divisions of the organ rather than following them. The lung is much the commonest site, although the same approach is used in the liver, the stomach and elsewhere.
What makes it different from other lung operations?
Every other way of removing lung tissue follows the architecture of the organ. The lung divides into lobes, each lobe into segments, and each segment carries its own airway, artery and vein that can be tied off cleanly. A wedge ignores those boundaries and lifts out a block of tissue, usually with a stapler that seals as it cuts. That makes the operation quicker and spares more breathing capacity, at the cost of a narrower margin of normal tissue and no systematic sampling of the lymph nodes draining the area.
How do the options compare?
| Operation | How much is removed | Follows anatomy |
|---|---|---|
| Wedge resection | A block containing the lesion | No |
| Segmental resection | A segment with its own vessels and airway | Yes |
| Lobectomy | A whole lobe | Yes |
| Pneumonectomy | An entire lung | Yes |
| Sleeve resection | A lobe with a cuff of airway, then rejoined | Yes |
When is it chosen?
Two situations account for most of them. The first is diagnosis. A small nodule of unknown nature can be taken out whole and examined while the person is still asleep, and the operation ends there if it turns out to be harmless. The second is treatment of a small cancer in someone whose lung capacity or general health could not absorb the loss of a whole lobe. It is also the usual way to remove a deposit that has spread to the lung from a cancer elsewhere, because those tend to sit near the surface and removing the minimum matters when several may need taking over the years. Set against a larger resection, recurrence close to the staple line is more frequent, so the choice weighs what the tumor demands against what the lungs can spare.
Also known as
Used in a sentence
A wedge resection of the right lower lobe was performed for the peripheral nodule.
Good to know
A wedge does not follow the segmental anatomy of the lung and includes no systematic lymph node sampling, so the margin of normal tissue around the lesion is narrower than after an anatomic resection.
Word origin
Where “wedge resection” comes from
Resection comes from the Latin resecare, to cut back or cut away.