Thoracic Surgery

Treatments and Procedures

Surgery professionals known as thoracic surgeons specialise in operations on the chest (thorax) and associated organs, such as the lungs, oesophagus, diaphragm, pleura (the small area between the lung and chest), and chest wall. Thoracic surgeons offer a variety of treatments and services, including the following:

Treatments

Open Thoracic Procedures

“Open” A wider incision is made on the chest wall during thoracic surgery, which gives the surgeon direct access to the problematic region. In open surgery, the surgeon often makes an incision on the side of the chest affected by the illness and carefully dissects through the muscles between the ribs to access the chest cavity. This is the typical and traditional method. It treats all conditions affecting the lungs, esophagus, trachea, pleura, and mediastinum in the chest. All-open thoracic treatments are usually only used in more complicated circumstances if a minimally invasive technique is either impossible or not anticipated to be effective enough to treat the patient's condition. The size and location of the afflicted region, the patient's general health, and lung function will all be considered when deciding whether to do an all-open thoracic operation. Discussing your treatment choices with a thoracic surgeon is critical to choose the best course of action for you. You can make an educated decision regarding your treatment by engaging with your surgeon to understand better the potential benefits and risks of all-open thoracic procedures.

Minimally Invasive Surgery

Thoracoscopic (minimally invasive) surgery, also known as Video-Assisted Thoracic Surgery (VATS), is a type of surgery that is performed using small incisions and specialized instruments, including a thoracoscope, which is a thin metal tube with a light and camera attached to it, thereby foregoing the need of making a big incision on the chest and placing the surgeon’s hands within the chest. This type of surgery is used to treat several disorders that affect the chest and lungs, including:

VATS – Video-assisted Thoracoscopic Surgery

Video-Assisted Thoracoscopic Surgery is known as VATS. Little incisions and a telescopic video camera are used to accomplish this kind of minimally invasive surgery. With VATS, a tiny incision in the chest is used to introduce a telescope with a camera that allows the surgeon to look inside the chest cavity without making a big incision. The surgical operation is then carried out by inserting special instruments through further minor incisions. For a number of thoracic operations, such as lung cancer surgery, pleural disease surgery, mediastinal tumour surgery, and diaphragm repair, VATS is frequently employed. Compared to conventional "open" surgery, VATS has a number of advantages, including:

  • Less pain: Because VATS is less intrusive than open surgery, it frequently results in less pain and suffering.
  • Quicker return to regular activities: Individuals who have VATS operations often recover more quickly than patients who have open surgery.
  • Smaller incisions: used in VATS operations lower the risk of infection and other problems.
  • Better cosmetic outcome: The tiny incisions utilised in VATS operations often leave fewer scars and produce a more aesthetically pleasing result.
  • Uniportal VATS – Single Incision VATS Surgery

    One tiny incision is used to execute the least invasive surgical method known as Uniportal VATS (Video-Assisted Thoracoscopic Surgery) (usually about 4-5 cm). Due to its potential advantages, the "multiportal" VATS has evolved into a more modern and appealing variant known as the "uniportal" VATS. All surgical tools, including the camera, are introduced during uniportal VATS through a single incision, which is commonly made in the patient's side or back. Via the same incision, the surgeon inserts specialised devices to carry out the surgery while using the camera to observe the inside of the chest cavity. For a number of thoracic operations, such as surgery for mediastinal tumours, pleural illness, and lung cancer, uniportal VATS is frequently employed. Compared to conventional VATS and open surgery, it may have a number of advantages, including:

  • Less pain and discomfort: Uniportal VATS is even less intrusive than conventional VATS and often results in less pain and discomfort.
  • Quicker return to regular activities: Individuals who have uniportal VATS operations often recover faster than patients who have open surgery.
  • Reduced risk of infection: Uniportal VATS lowers the risk of infection and other problems by using a single, tiny incision.
  • Better cosmetic outcome: The single, tiny incision utilised in uniportal VATS usually leaves even less scarring and a more aesthetically pleasing result.
  • Procedures

    Lung surgery

    A series of surgical techniques used to treat illnesses including lung cancer, pneumonia, and emphysema are referred to as lung surgery. Several types of lung operations can be carried out, depending on the requirements and health of the patient. Many frequent procedures for the lung include:

  • Lobectomy: The most frequent kind of surgery for lung cancer is a lobectomy, which involves removing a lung lobe. Both an all-open thoracic approach and minimally invasive methods, such as video-assisted thoracic surgery (VATS), can be used to carry out this treatment.
  • Pneumonectomy: A pneumonectomy is an operation in which the entire lung is removed. This treatment is often used for more advanced lung malignancies when a lobectomy is ineffective for curing the illness or when a persistent infection has "destroyed" the entire lung.
  • Segmentectomy: A lung segment is removed during a segmentectomy (the fundamental unit of lung tissue). Smaller tumours or situations where a lobectomy would cause a severe loss of lung function are the usual candidates for this operation. It benefits individuals who are not well enough for a lobectomy by maintaining lung function.
  • Wedge Resection: This surgical operation, usually used for small, peripheral tumours or in individuals who are not candidates for lobectomy or segmentectomy, entails the removal of a tiny, wedge-shaped portion of lung tissue.
  • Sleeve resections: In this procedure, a portion of the lung (often a lobe) and its major bronchus (supplying airway) are removed. The remaining healthy bronchus' cut ends are then joined, conserving the lung's connected, healthier portion.
  • Bullectomy/Blebectomy: Excision of an aberrant lung cavity filled with air.
  • Pleural Disease Surgery

    Surgery to treat disorders that affect the pleura, the slender layer of tissue that protects the lungs and borders the chest cavity, is referred to as pleural illness surgery. A variety of symptoms, including coughing, breathing problems, and chest discomfort, can be brought on by pleural illness. Pleural disease surgery aims to cure the underlying cause of the problem as well as reduce symptoms and enhance lung function. Some frequent pleural disease surgical procedures include:

  • Pleural biopsy: A tiny sample of pleural tissue is removed during a pleural biopsy in order to be examined under a microscope. This method is used to identify conditions that affect the pleura, such as mesothelioma, a kind of cancer.
  • Pleurodesis: This operation keeps fluid from accumulating in the pleural cavity, or the area between the lungs and the chest wall. Both an all-open thoracic approach and a less invasive technique, such as video-assisted thoracic surgery (VATS), can be used to accomplish pleurodesis.
  • Chest Wall Reconstruction

    A group of surgical treatments known as "chest wall reconstruction" are carried out to repair and reconstruct the chest wall, which is the framework that encircles the heart, lungs, and other internal organs in the chest. Several different diseases, including the following, are treated by chest wall reconstruction:

  • Chest wall deformities: These include disorders where the chest wall is deformed, such as pectus excavatum (sunken chest) and pectus carinatum (pigeon chest). To rectify these defects and enhance the chest's look and functionality, chest wall reconstruction might be done.
  • Chest Wall Tumors: They can grow in the bones, muscles, or other tissues that make up the chest wall. When the tumours have been removed, the chest wall can be repaired by chest wall reconstruction.
  • Chest Wall Injuries: such as fractures or other harm to the muscles or bones of the chest wall to fix the damage and return the chest wall to its original form and functionality, chest wall reconstruction may be necessary.
  • Esophageal Surgery

    Esophageal surgery is a type of surgery used to repair problems with the oesophagus, the muscular tube that links the mouth and stomach. Food and liquids must be transported from the mouth to the stomach for digestion via the oesophagus. Esophageal surgery is frequently used to address ailments like:

  • Esophageal Cancer: The oesophagus is treated by having malignant tissue removed.
  • Barrett's Esophagus: The oesophagus must be cleared of aberrant tissue after being harmed by acid reflux.
  • Achalasia: The oesophagus is widened to allow for better food and liquid movement to the stomach.
  • Hiatal Hernia: Repairing a hernia in the diaphragm that causes a portion of the stomach to protrude into the chest is known as a hiatal hernia.
  • Esophageal stricture: The widening of a narrow portion of the esophagus to improve the flow of food and liquids to the stomach.
  • VATS Diaphragm Repair

    A diaphragm defect or damage can be treated using a minimally invasive surgical method called a VATS (Video-Assisted Thoracoscopic Surgery) diaphragm repair. The diaphragm is the muscular wall that divides the chest and abdominal compartments. Normal breathing depends on the diaphragm because it helps to regulate the flow of air into and out of the lungs. A small camera and other tools are placed through tiny abdominal or chest incisions during a VATS diaphragm repair. The defect or damage is then fixed using sutures, mesh, or other surgical supplies after the surgeon utilises the camera to inspect the diaphragm and the nearby tissues. When opposed to conventional "open" surgery, VATS diaphragm repair provides a number of advantages. These advantages include:

  • Less discomfort and agony: Since VATS diaphragm repair is less intrusive than open surgery, it frequently results in less pain and discomfort.
  • Quicker return to normal activities: Patients who have VATS diaphragm repair often heal more rapidly than those who have open surgery and can resume their regular activities more immediately.
  • Reduced risk of infection: The VATS diaphragm repair procedure uses fewer incisions, which lowers the risk of infection and other problems.
  • Better aesthetic outcome: The tiny incisions used in VATS diaphragm repair often leave less scars and produce a more attractive result.
  • VATS Decortication

    Video-Assisted Thoracic Surgery (VATS) Thoracic surgeons use the minimally invasive surgical method of decortication to treat pleural thickness or pleural fibrosis. This disorder causes the pleural cavity, or the area between the lungs and the chest wall, to fill with fibrous tissue, which compresses the lungs and makes breathing difficult. The pleura is "decorated" during a VATS decortication surgery when the surgeon makes many tiny incisions in the patient's chest, inserts a camera, and uses specialised tools to remove the fibrous tissue from the pleural space. This enhances the patient's capacity to breathe by allowing the lung to expand and reducing compression. A less invasive method than an open thoracotomy, which traditionally entails creating a major incision in the chest to access the pleural chamber, is VATS decortication. A speedier recovery, less discomfort, and a lesser chance of complications are just a few benefits of VATS decortication versus open thoracotomy. It's critical to explore your treatment options with a thoracic surgeon if you have been diagnosed with pleural thickening or fibrosis in order to decide the best course of action for you.

    VATS Lobectomy

    Video-Assisted Thoracic Surgery (VATS) Thoracic surgeons use a minimally invasive surgical operation called a lobectomy to remove a lobe, or section, of the lung. As opposed to a huge incision used in a standard open thoracotomy, multiple tiny incisions are made in the chest to accomplish the treatment. The most prevalent type of lung cancer surgery is the lobectomy, which is frequently used to treat the disease. A camera and specialised equipment are inserted by the surgeon during a VATS lobectomy to access and remove the afflicted lobe. While the remaining healthy lung tissue is retained, healing and return to regular activities are sped up. Compared to open thoracotomy, VATS lobectomy provides a number of benefits, including less discomfort, a speedier recovery, and a decreased risk of complications. Nevertheless, not all patients are candidates for VATS lobectomy, and the choice to carry out the treatment will be based on elements including the size and location of the tumour as well as the patient's general condition.

    VATS Pneumonectomy

    Video-Assisted Thoracic Surgery (VATS) Thoracic surgeons use a minimally invasive surgical technique called a pneumonectomy to remove a complete lung. As opposed to a huge incision used in a standard open thoracotomy, multiple tiny incisions are made in the chest to accomplish the treatment. Advanced lung cancer and other illnesses that involve the entire lung and cannot be treated with conventional surgical procedures are frequently treated with a pneumonectomy. A camera and specialised equipment are inserted by the surgeon during a VATS pneumonectomy to access and remove the afflicted lung. As comparison to open thoracotomy, VATS pneumonectomy provides a number of benefits, including reduced discomfort, a speedier recovery, and a lesser risk of complications. The choice to undertake the treatment will be based on the patient's general health, the patient's lung function, the size and location of the tumour, and other variables. Unfortunately, not all patients are suited for VATS pneumonectomy. If you have a condition that affects both of your lungs and have been told you need to have a pneumonectomy, it's important to discuss your options with a thoracic surgeon to determine the best course of action for you. Working with your surgeon to better comprehend the potential benefits and risks will enable you to make an educated decision on your care.

    VATS Metastasectomy

    Video-Assisted Thoracic Surgery (VATS) To remove metastatic cancers that have progressed to the lungs from another region of the body, thoracic surgeons use a minimally invasive surgical operation called a metastasectomy. Instead of a single major incision as with an open thoracotomy, the surgery is carried out through a series of minor incisions in the chest. A camera and specialised equipment are inserted by the surgeon during a VATS metastasectomy to access and remove the metastatic tumours from the lung tissue. The treatment aims to lessen the patient's symptoms and, in some situations, increase their longevity. VATS metastasectomy has several advantages over open thoracotomy, including less pain, a quicker recovery time, and a lower risk of complications. However, not all patients are suitable for VATS metastasectomy, and the decision to perform the procedure will depend on factors such as the size and location of the metastases, the overall health of the patient, and the patient's lung function.

    VATS Bullectomy

    Video-Assisted Thoracic Surgery (VATS) Thoracic surgeons who conduct bullectomy execute a minimally invasive surgical operation to remove a bulla, an air-filled chamber that develops in the lung. Emphysema and other lung disorders can cause a bulla to form, which can cause the lung to collapse and make breathing difficult. Many tiny incisions are made in the chest during a VATS bullectomy so that the surgeon may introduce a camera and other specialised tools to reach the damaged lung and remove the bulla. The procedure's aim is to make the patient's breathing and quality of life better. Compared to a conventional open thoracotomy, a VATS bullectomy has fewer side effects, a speedier recovery period, and a decreased risk of complications. The choice to undertake the treatment will be based on the patient's general health, the patient's lung function, the size and location of the bulla, and other considerations. Unfortunately, not all patients are suited for VATS bullectomy. If you have been diagnosed with a bulla in your lung and are experiencing breathing difficulties, it is critical to discuss your treatment options with a thoracic surgeon to determine the best course of action for you.

    VATS Pleural Biopsies/ Pleurodesis:

    VATS Thoracic surgeons use the minimally invasive surgical procedure known as pleural biopsy/pleeurodesis to remove a sample of pleural tissue for testing or to treat pleural effusions. Fluid can accumulate in the pleural cavity, which is the area around the lungs, causing pleural effusions. In order to reach the pleural cavity and collect a tissue sample during a VATS pleural biopsy, the surgeon makes numerous tiny incisions in the patient's chest and inserts a camera and specialised equipment. The sample is subsequently sent to a lab for investigation to identify the pleural effusion's underlying cause and inform therapy. By forming an adhesion between the pleural membranes and successfully closing off the pleural cavity, VATS pleurodesis is a treatment used to reduce pleural effusions. With a tiny incision in the chest, the treatment is carried out by injecting a material, such as talc, into the pleural cavity. In comparison to open thoracotomies, VATS pleural biopsy/pleurodesis provides a number of benefits, including reduced discomfort, a speedier recovery, and a decreased risk of complications. Nevertheless, not every patient is a candidate for VATS pleural biopsy/pleurodesis, and the choice to carry out the treatment will rely on elements including the patient's general health and lung function. Your surgeon can help you comprehend the possible benefits and drawbacks of various treatments while you're picking one.

    VATS Thymectomy

    VATS Thoracic surgeons undertake thymectomy, a minimally invasive treatment, to remove the thymus gland, which is situated in the chest behind the sternum and in front of the heart. The thymus gland plays a crucial role in immune system development, but it can occasionally acquire a disease or expand, leading to symptoms including chest discomfort, shortness of breath, and difficulty swallowing. In order to reach the thymus gland and remove it during a VATS thymectomy, the surgeon creates a number of tiny incisions in the patient's chest. The procedure's objectives include symptom relief and, occasionally, immune system improvement for the patient. In comparison to a conventional open thoracotomy, a VATS thymectomy has a number of benefits, including less discomfort, a quicker recovery, and a lower risk of complications. But not all patients are candidates for VATS thymectomy, and the choice to carry out the procedure will be based on elements like the size and location of the thymus gland, the patient's general health, and the patient's lung function.

    VATS Mediastinal Tumor Resection

    VATS Thoracic surgeons use a minimally invasive surgical method called mediastinal tumour resection to remove tumours from the mediastinum, the region of the chest between the lungs. The complex region known as the mediastinum is home to vital organs including the heart, trachea, oesophagus, and blood arteries. Tumors in this region can result in symptoms like chest discomfort, shortness of breath, and difficulty swallowing. A camera and specialised devices are inserted via many tiny chest incisions made during a VATS mediastinal tumour excision in order to access the afflicted area and remove the tumour. The procedure's objectives are to enhance the patient's prognosis, ease symptoms, and eliminate malignant tissue. As comparison to a standard open thoracotomy, VATS mediastinal tumour excision provides a number of benefits, including less discomfort, a speedier recovery, and a lower risk of complications. The choice to undertake the treatment will be based on the size and location of the tumour, the patient's general health, and the patient's lung function. Unfortunately, not all patients are suited for VATS mediastinal tumour excision.

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