In addition to surgical procedures involving the heart, veins, and arteries, our surgical team is also skilled in performing thoracic surgery. Thoracic surgery involves the treatment of lungs, esophagus, trachea (windpipe), ribs and breastbone. Learn about some of the more common thoracic disorders and treatments below.
Lung and esophageal cancer
Lung cancer is a type of cancer that begins in the lungs. Your lungs are two spongy organs in your chest that take in oxygen when you inhale and release carbon dioxide when you exhale. Health care providers divide lung cancer into two major types based on the appearance of lung cancer cells under the microscope. Your health care team makes treatment decisions based on which major type of lung cancer you have.
The two general types of lung cancer include:
- Small cell lung cancer — small cell lung cancer occurs almost exclusively in heavy smokers and is less common than non-small cell lung cancer.
- Non-small cell lung cancer — non-small cell lung cancer is an umbrella term for several types of lung cancers. Non-small cell lung cancers include squamous cell carcinoma, adenocarcinoma and large cell carcinoma.
A paraesophageal hernia occurs when the lower part of the esophagus, the stomach, or other organs move up into the chest. Any paraesophageal hernia should be repaired anytime it is causing symptoms. Common symptoms include:
- Chest pain
- Pain in the middle, upper abdomen
- Difficulty swallowing
- Shortness of breath
- Early or prolonged satiety
- Stomach ulcers
Symptomatic paraesophageal hernias are at higher risk for progressing to incarceration (stomach getting stuck resulting in obstruction) or ischemia (blood supply to the stomach is cut off) resulting in the need for emergency surgery.
Paraesophageal hernias are often repaired laparoscopically through five small incisions through the abdomen. During surgery, the stomach is gradually moved back into the abdominal cavity. The area is then closed to prevent re-herniating.
A pleural effusion is the build-up of excess fluid between the layers of the pleura outside the lung. The pleura are thin membranes that line the lungs and the inside of the chest cavity to act as a lubricant and to help facilitate breathing. Common causes of pleural effusions include:
- Heart failure
- Pulmonary embolism
- Post open-heart surgery
- Pulmonary embolism
- Kidney disease
Treatment of pleural effusion is based on treating the underlying condition and whether the effusion is causing severe respiratory symptoms.
A pneumothorax (noo-moe-THOR-aks) is a collapsed lung. A pneumothorax occurs when air leaks into the space between your lung and chest wall. This air pushes on the outside of your lung and makes it collapse. A pneumothorax can be a complete lung collapse or a collapse of only a portion of the lung.
A pneumothorax can be caused by a blunt or penetrating chest injury, certain medical procedures, damage from underlying lung disease, or it may occur for no obvious reason. Symptoms usually include sudden chest pain and shortness of breath. On some occasions, a collapsed lung can be a life-threatening event.
The goal in treating a pneumothorax is to relieve the pressure on your lung, allowing it to re-expand. Depending on the cause of the pneumothorax, a second goal may be to prevent recurrences. The methods for achieving these goals depend on the severity of the lung collapse and sometimes on your overall health.
Treatment options may include observation, needle aspiration, chest tube insertion, nonsurgical repair or surgery. If surgery is necessary to close the air leak, in most cases, the surgery can be performed through small incisions, using a tiny fiber-optic camera and narrow, long-handled surgical tools.
Depending on your lung condition or type of lung cancer, you may be a candidate for robotic thoracic surgery. Traditional thoracic surgery requires a sternotomy, or a long incision along the breast bone, spreading the ribs apart. During robotic surgery, our surgeons can perform surgery through a few small incisions. They then use a robotic system, which includes a camera arm and several interactive mechanical arms, with joints that work like a human's wrist. Your surgeon guides the procedure from a remote console a few feet from the surgical table and views the surgical area in a 3-D magnified view on a monitor, which offers greater depth perception and detailed views than does open surgery.
From the remote console, your surgeon uses two hand-and-finger devices to precisely direct the mechanical arms at the operating table.
Surgeons have more flexibility, control and maneuverability using the surgical instruments in robotic surgery than in traditional minimally invasive surgery. Other patient benefits include:
- Less pain
- Less blood loss
- Less scarring
- Shorter recovery time and faster return to normal activities