Thoracic Surgery

Thoracic Surgery

Thoracic surgery focuses on the areas within the chest cavity, including the lungs, esophagus, chest wall and all major blood vessels in the chest. In addition to treating benign diseases of the chest cavity, thoracic surgeons treat cancer within the chest including lung cancer. Meet our board-certified thoracic surgeon and review some of the common thoracic procedures.

Bronchoscopy

Bronchoscopy is a technique of visualizing the inside of the airways for diagnostic and therapeutic purposes. An instrument (bronchoscope) is inserted into the airways, usually through the nose or mouth, or occasionally through a tracheostomy. This allows the practitioner to examine the patient’s airways for abnormalities such as foreign bodies, bleeding, tumors, or inflammation. Specimens may be taken from inside the lungs. The construction of bronchoscopes ranges from rigid metal tubes with attached lighting devices to flexible optical fiber instruments with realtime video equipment.

Esophagectomy

Definition/Overview

An esophagectomy is a procedure for the treatment of esophageal disorders including esophageal cancer.

Procedure

In this procedure, which is performed under general anesthesia, the part of the esophagus that contains the cancer and nearby lymph nodes are removed. The surgeon either attaches the esophagus directly to the stomach or replaces the removed part of the esophagus with a piece of intestine.

Transhiatal Esophagectomy (THE)

In some cases, a transhiatal esophagectomy (THE) may be performed. Incisions are made in the upper abdomen as well and the neck. Part of the esophagus is removed and part of the stomach is cut into a tube shape and is also removed. The stomach portion is then moved upward through the chest and connected to the small piece of the esophagus remaining in the neck.

Laparoscopic Esophageal Surgery

This procedure is minimally invasive and performed using small incisions through which specialized equipment and cameras are inserted. This surgery is not appropriate for all patients requiring esophageal surgery. Your physician will determine which surgical approach is best suited to your situation.

Aesthetic Services

Esophagoscopy is a technique for screening for esophageal cancer and other disorders. Esophagoscopy has been used by otolaryngologists since 2000 as a diagnostic tool to detect globus, dysphagia, laryngopharyngeal reflux, and gastroesophageal reflux disease.

Lobectomy (Lung)

Definition/Overview

A lobectomy is the surgical removal of one entire lobe (section) of a lung. The procedure may be performed when an abnormality has been detected in a specific part of the lung. The affected lobe is removed, and the healthy tissue remains. A lobectomy is preformed in early stage NSCLC patients (where cancer has not spread). A lobectomy is normally performed during a thoractomy.

Procedure

A lobectomy is an inpatient procedure and requires general anesthesia. During the procedure, an incision is made in the chest and the ribs spread apart to allow adequate viewing of the lung. Blood vessels and air tubes that supply the lobe being removed will be tied off with sutures. The lobe is removed and possibly a portion of a rib as well. The surgeon places a drainage tube or tubes in the chest to drain fluid that may build up in the chest. You may be given an epidural catheter in order to administer pain medication.

You will normally spend the first day after surgery in the ICU (Intensive Care Unit), followed by a hospital stay of up to a week or more. You may need to receive oxygen in the hospital, and possibly after being discharged. The drainage tube will be removed after a few days or until fluid is no longer present. You will work with a respiratory therapist while in the hospital to aid in recovery, and will be given deep-breathing exercises and coughing techniques to help facilitate lung re-expansion and prevent pneumonia.

Lymphadenectomy

Lymphadenectomy is the surgical removal of one or more groups of lymph nodes. It is almost always performed as part of the surgical management of cancer. In a regional lymph node dissection, some of the lymph nodes in the tumor area are removed; in a radical lymph node dissection, most or all of the lymph nodes in the tumor area are removed. It is usually done because many types of cancer have a marked tendency to produce lymph node metastasis early in their natural history. This is particularly true of melanoma, head and neck cancer, differentiated thyroid cancer, breast cancer, lung cancer, gastric cancer and colorectal cancer.

Thoracoscopy

Definition/Overview

A thoracoscopy is a procedure that utilizes an endoscope to examine the pleura, lungs and mediastinum, and to obtain tissue for testing purposes. This procedure is done to assess lung cancer, take a biopsy for study, determine the cause of fluid in the chest cavity, introduce medications or other treatments directly into the lungs, and to treat accumulated fluids in the space around the lungs. This procedure is sometimes done as an alternative to a thoracotomy.

Procedure

This is an inpatient procedure using general anesthesia. The surgeon will make several, small incisions in your side and insert a thoroscope containing a tiny camera through one of the incisions. The surgical instruments are inserted through the other incisions. The lung to be examined is deflated to create a space between the chest wall and the lung. The patient breathes with the other lung as well as with assistance from a ventilator. Using the camera as a guide, the surgeon takes tissue samples and reinflates the lung.

The surgeon closes the incisions except for one in which a chest tube is inserted to drain fluid and air from the incision site. The chest tube will remain for several days, and your hospital stay will typically range from two to five days. Medications for pain are given as needed, and you will have restrictions on lifting and other activities for several weeks.

Wedge Resection

Definition/Overview

A wedge resection is the surgical removal of a small portion of the long along with the healthy tissue surrounding the lung. The procedure is performed to remove a lung tumor, or to aid in the diagnosis of lung cancer.

Procedure

This is an inpatient procedure and you will be given general anesthesia. The surgeon will perform a thoracotomy (an incision to open up one side of the chest), and will remove a wedge-shaped section of the lung. A chest tube may be inserted to allow draining of fluids that may build up in the lung.

Your hospital stay will usually be around a week, and you will be given respiratory therapy during that time to aid in recovery, facilitate lung function and prevent pneumonia.

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