Thoracic surgery

Thoracic surgery refers to operations on organs in the chest, including the heart, lungs and esophagus. Examples of thoracic surgery include coronary artery bypass surgery, heart transplant, lung transplant and removal of parts of the lung affected by cancer. Specialized thoracic surgeons treat lung and esophageal cancer, while specialized cardiac surgeons treat the heart.

Thoracic surgery and cancer

Thoracic surgery, also known as chest surgery, may be used to diagnose or repair lungs affected by cancer, trauma or pulmonary disease. For lung cancer, the surgeon may remove nodules, tumors and lymph nodes to diagnose, stage and treat the disease.

Thoracic surgery procedures may be performed with minimally invasive techniques or an open surgical procedure called a thoracotomy. The surgeon may opt for a thoracotomy when it is necessary to see large portions of the lung or inner chest cavity. The procedure may be performed to remove the entire lung or a portion of the lung.

Thoracotomy procedures

A thoracotomy to treat lung cancer may be performed using one of the following procedures:

• Wedge resection removes the tumor and tissue surrounding the cancer.
• Anatomical segmental resection removes the tumor, the blood vessels, the lymphatic drainage and the lung segment where the tumor is located.
• Lobectomy removes the entire lobe of the lung that has cancer, including the lymph nodes.
• Pneumonectomy removes the whole lung with the lymph nodes.
• Pleurectomy removes the inner lining of the chest cavity.

Minimally invasive thoracic surgeries

Minimally invasive thoracic surgeries that may be performed to treat cancer include those listed below.

• Video-assisted thoracic surgery (VATS): During this operation, the surgeon inserts a long, thin tube with an attached camera through a small incision in the chest. This instrument is called a thoracoscope. Special instruments also are inserted through small incisions in the chest. The surgeon operates while watching the video from the thoracoscope on high-resolution monitors in the operating room.
• Robotic thoracic surgery: Like VATS, this procedure allows the surgeon to view the surgical site via a camera inserted in the chest. The surgeon operates at a console, using controls that translate the surgeon’s hand, wrist and finger movements into movements of the instruments inserted in the chest.