Cardiothoracic surgery (also known as thoracic surgery) is the field of medicine involved in surgical treatment of organs inside the thorax (the chest)—generally treatment of conditions of the heart (heart disease) and lungs (lung disease). In most countries, cardiac surgery (involving the heart and the great vessels) and general thoracic surgery (involving the lungs, esophagus, thymus, etc.) are separate surgical specialties; the exceptions are the United States, Australia, New Zealand, and some EU countries, such as the United Kingdom and Portugal.
Thoracic surgery focuses on the chest organs, including the heart, lungs, esophagus, and trachea. Technological advances have increased the safety and availability of these complex surgical procedures. Lung cancer surgeries, heart transplants, and anti-reflux surgeries save and improve lives around the world.
Types of Thoracic (Lungs & Chest) Surgeries
VATS
Video-assisted thoracoscopic surgery
Video-assisted thoracoscopic surgery (VATS) is a type of thoracic surgery performed using a small video camera that is introduced into the patient’s chest via small incisions. The surgeon is able to view the instruments that are being used along with the anatomy on which the surgeon is operating. The camera and instruments are inserted through separate holes in the chest wall also known as “ports”. These small ports are advantageous because the chance for infection and wound dehiscence are drastically reduced. This allows for a faster recovery by the patient and a greater chance for the wound to heal.
Conventional Lung Surgeries
A lobectomy is a surgery to remove one of the lobes of the lungs. … The affected lobe is removed, and the remaining healthy lung tissue can work as normal. A lobectomy is most often done during a surgery called a thoracotomy. During this type of surgery, the chest is opened.
Types of conventional surgeries
- Pneumothorax
- Lobectomy
- Segmentectomy
- Decortication
- Thoracoplasty
Pneumothorax
A pneumothorax is a condition of the collapsed lung. It occurs when air leaks into the space between your lung and chest wall. This air pushes on the outside of your lungs and makes it collapse. 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, or damage from underlying lung disease. Treatment for a pneumothorax usually involves inserting a needle or chest tube between the ribs to remove the excess air. Sometimes, surgery may be necessary to close the air leak, usually performed through small incisions, using a tiny fiber-optic camera and narrow, long-handled surgical tools. The surgeon will look for the leaking area or ruptured bleb and close it off.
Lobectomy
A lobectomy is a surgery to remove one of the lobes of the lungs. The lungs have sections called lobes. The right lung has 3 lobes. The left lung has 2 lobes. A lobectomy may be done when a problem is found in any part of a lung. The affected lobe is removed so that the remaining healthy lung tissue can work as normal. A lobectomy is most often done by a surgery called a thoracotomy.
Segmentectomy
A segmentectomy involves the removal of part of one of the lobes of the lung to entirely remove a cancerous tumor. Segmentectomy may be recommended over lobectomy (where one entire lobe of the lung is removed) if the patient has a highly reduced lung reserve. Due to the increasingly earlier detection of lung cancer, it may not always have a significant benefit over segmentectomy.
Decortication
Decortication is a medical procedure involving the surgical removal of the surface layer, membrane, or fibrous cover of an organ. The procedure is usually performed when the lung is covered by a thick, pleural peel restricting lung expansion. Decortication is a major thoracic operation that has traditionally required a full thoracotomy. This procedure has increasingly been performed using more minimally invasive thoracoscopy. All fibrous tissues are removed from the visceral pleural peel and pus is subsequently drained from the pleural space.
Thoracoplasty
Thoracoplasty is a surgical procedure that was originally designed to permanently collapse the cavities of pulmonary tuberculosis by removing the ribs from the chest wall. It involves resection of multiple ribs, allows the apposition of parietal to the visceral or mediastinal pleura. Until supplanted by effective chemotherapy.