Thoracic surgery encompasses invasive procedures utilized to diagnose and treat diseases and disorders of the chest organs. Surgeons perform an array of different thoracic surgery procedures, increasingly employing minimally invasive surgical techniques to decrease recovery time and avoid risks associated with open chest procedures. The lungs are commonly the focus of thoracic surgery.
Lung Volume Reduction Surgery
Lung volume reduction surgery is a therapeutic procedure for people with severe emphysema in which diseased areas of the lungs are removed to facilitate improved function in the remaining lung tissue. Patients with emphysema primarily limited to the upper areas of the lungs are most likely to benefit from lung volume reduction surgery, reports the Cleveland Clinic.
Lung volume reduction surgery may be performed by opening the chest near the breastbone and exposing the lungs. Alternatively, a minimally invasive approach may be employed using a thoracoscope--a device inserted through the chest wall that allows the surgeon to visualize the lungs and perform surgery through the instrument.
Thymectomy
The thymus gland is a small immune system organ situated behind the breastbone. Tumors called thymomas may arise in the thymus, necessitating removal of the gland. The thymus is also routinely removed in patients with myasthenia gravis--an autoimmune neuromuscular disorder--facilitating remission of the disease in 30 to 40 percent of patients undergoing the procedure, notes Stanford University School of Medicine.
Thymectomy, or surgical removal of the thymus gland, is usually performed with an open chest procedure for patients with thymoma. Therapeutic thymectomy for patients with myasthenia gravis is commonly performed through an incision at the base of the neck, a procedure known as a transcervical thymectomy.
Lung Resection
A lung resection is the surgical removal of all or part of the lung. Most commonly, lung resections are performed on patients with early-stage lung cancer. The amount of lung tissue removed depends on the size, location and spread of the cancer within the chest, explains Columbia University Medical Center Department of Surgery.
The lungs have discrete lobes, two in the left lung and three in the right lung. A lobectomy involves removal of a single lung lobe. This procedure is utilized for patients with a small cancerous lung tumor and no evidence of spread outside the affected lobe. Larger cancerous tumors require removal of the entire affected lung, a procedure known as a pneumonectomy.
Surgeons frequently employ video-assisted thoracic surgery techniques, or VATS, to perform lobectomies. This minimally invasive procedure involves performing surgery with specially designed instruments inserted into the chest cavity through small incisions. The chest muscles, breastbone and ribs remain intact. VATS may be employed for pneumonectomy, although an open chest procedure is often required due to tumor size or location.
References
- Cleveland Clinic: Lung Volume Reduction Surgery--Diagnosis and Treatment
- Duke Medicine: Lung Volume Reduction Surgery
- Stanford School of Medicine, Thoracic Surgery: Mediastinal Diseases and Masses / Thymoma
- Columbia University Medical Center, Department of Surgery: Lung Cancer Treatments
- Brigham and Women's Hospital, The Division of Thoracic Surgery: Minimally Invasive Thoracic Surgery
