General Thoracic Surgery
General Thoracic Surgery is surgery that involves the chest excluding the heart.
At Carson Surgical Group, we treat many diseases that affect the chest to include esophageal cancer, lung cancer, mediastinal tumors, pneumothorax (lung collapse), empyema (infections inside the chest cavity) and hyperhidrosis (excessive sweating in the palms and armpits). While many of these surgeries were traditionally done open, the majority of cases can now be treated with minimally invasive techniques.
The mediastinum is the term used to describe the center of the chest cavity. It can be broken up into Anterior (front), Middle, and Posterior (back).
Tumors that affect the Mediastinum are based upon the structures in that section. Anterior mediastinal tumors include the 4 “T’s”: Teratoma, Thymoma, Thyroid, and T-cell Lymphoma.
Middle mediastinal tumors are often tumors affecting the heart such as Atrial Mixoma. Posterior Mediastinal tumors includes paraganglionoma and Schwanoma to name a few. The traditional approach to these tumors has been from a Sternotomy (Opening the Breast plate as in a heart bypass surgery, or from a Thoracotomy (Opening on the side and spreading the ribs.) Now, nearly all of these tumors can be treated minimally invasively.
Pneumothorax is the collapse of the lung within the chest.
You can think of the lung like an inner tube contained within a tire (the chest wall). A Pneumothorax occurs when the lung (the inner tube) has a hole in it and collapses in the chest. This can occur in young patients as a result of “blebs” (blisters) on the lung that leak air into the chest. It can also occur in older patients, usually as a result of damage to the lung from smoking. Pneumothorax can almost always be treated with minimally invasive surgery.
Empyema (Pronounced: “M-Pi-E-Ma”)
Empyema is an infection that occurs between the lung and chest wall.
If we think again about the example of the inner tube and tire to represent the lung and the chest wall, an Empyema occurs when there is an infection that develops in the space between the lung (the inner tube) and the chest wall (the tire). This infection can progressively collapse the lung and cause severe illness and even death. Treatment of these infections is with surgery and antibiotics. Surgery can be very difficult and has often been done with an open thoracotomy (cutting into the side of the chest and spreading the ribs to access the chest cavity.) Within the last few years, advances in minimally invasive techniques and instrumentation has changed this surgery to a minimally invasive procedure.
According to the American Cancer Society, lung cancer is the second most common cause of cancer in Men (Prostate is number 1) and Women (Breast is number 1). About 13% of all new cancers are lung cancers. Approximately 228,150 new cases of lung cancer are diagnosed per year and approximately 142,670 deaths occur from lung cancer per year.
Treatment for lung cancer is based upon the stage of the cancer; the earlier the stage, the more likely that the patient can be cured. The best treatment for early stage lung cancer is surgery to remove the tumor. The surgery often involves removing a lobe of the lung (part of the lung) and the lymph nodes that drain that section of the lung. Rarely, the entire lung must be removed. Nearly all of the lung resections for cancer can now be done minimally invasively
VATS (Video Assisted Thoracic Surgery)
VATS is a type of thoracic surgery performed using a small video camera that is introduced into the patient’s chest via a scope. The surgeon is able to view instruments that are being used along with the anatomy on which the surgeon is operating. It is a minimally invasive surgical technique which can be used for many purposes, ranging from a biopsy to removal of tumors or entire lobes from the lung. VATS has revolutionized the treatment of diseases of the chest resulting in less pain, decreased hospital stays, and a more rapid recovery and return to normal activities.