Minimally Invasive Chest Surgery and Thoracic Surgical Oncology

Minimally Invasive Surgery

Robotic Thoracic Surgery

Robotic thoracic surgery is robot-assisted, minimally invasive surgery.  This innovation enhances the ability of the surgeon, providing greater range of motion, surgical precision, and enhanced visualization in less space.  As a result, smaller incisions are required which reduces hospital stay, patient recovery time, and risk of infection.

Lung cancer surgery

Lung cancer surgery may require the removal of a piece of the lung (resection), lobe (lobectomy), or the entire lung (pneumonectomy).  These techniques are considered final treatments, which factor in the patient’s total lung function and the amount of lung tissue removal to hinder the spread of cancer.  Lung surgery may also be accompanied by other treatments including radiation therapy and chemotherapy, as with treatment for chest wall tumors.

Volume Reduction Surgery of the Lung

Patients with severe emphysema can achieve a better quality of life through surgery. Approximately 75 percent of advanced emphysema patients who undergo volume reduction surgery will no longer need an oxygen inhaler after their recovery.  Volume reduction is the resection of both upper lobes of the lungs.

Surgery for special conditions

Benign Esophageal Disease

Surgery is not the primary treatment for benign esophageal disease, but more to remedy medical treatments that have not been as effective.  Other procedures involving surgery include vagal-sparing esophagectomy, anti-reflux procedure, and esophageal lengthening.  Primary treatments of benign esophageal disease include medication, dilation (expanding a narrow portion of the esophagus), and the use of stents for conditions where dilation has not been productive.

Malignant Esophageal Disease

Surgery to remove cancer of the esophagus may be accompanied by other treatments, such as radiotherapy. Typically, esophageal surgery is common for the removal of very small tumors that have not spread to other areas.  These early-stage cancers can be treated without an external incision using an endoscope.  More developed esophageal cancer may require the removal of a portion of the esophagus (esophagectomy), requiring the stomach to be reconnected to the esophagus.

Myasthenia Gravis

Myasthenia Gravis is a disorder that leads to weakness in muscles, such as in the face, limbs, and eyes.  It can be treated with medication, such as immunosuppressants, and also by removing the thymus gland, which is located in the front-center of the chest.  Surgical removal of the gland (thymectomy) may benefit some individuals by re-balancing the immune system.  Thymectomy is also recommended for individuals with thymoma with mild to moderate muscle weakness.

Mediastinal Tumors

Mediastinal tumors are growths that form in the chest area, surrounded by the breastbone, spine, and lungs on either side. These tumors require surgical resection and may require radiotherapy to help reduce the risk of cancer spread. Minimally invasive surgical techniques, including thoracoscopy or robot-assisted surgery, are common methods of treatment for mediastinal tumors.  Thymic cancers, which forms on the outside surface of the thymus gland, often require surgery, radiation, and chemotherapy.

Thoracic Outlet Syndrome

Thoracic outlet syndrome presents as shoulder and neck pain caused by compressed nerves or blood vessels below the neck.  Typically, non-surgical interventions such as adjusting one’s activities, posture, exercise routine, etc., are recommended.  Surgery is generally a last resort because it involves making structural changes in the body around the area of compression.

For additional thoracic conditions, please see Thoracic Conditions.

New James J. Toth, Sr. Lung Screening Program for Smokers at Saint John’s Health Center

Our new lung screening program is designed to help current and former smokers develop regular examination habits to assess their lung health, including worsening or cancerous conditions. The program also helps non-smokers with screening. Based on your age and smoking habits, screening may be the best way to manage your health moving forward.  Most screening results are negative for cancer, but if lung cancer is found, treatment can begin sooner and may be less invasive, which leads to faster recovery.  Your doctor has greater treatment options and interventions if cancer is discovered early.

What is the James J. Toth, Sr. Lung Screening Program?

The James J. Toth, Sr. lung screening program at Saint John’s Health Center is for smokers to help identify cancer early, thereby providing greater treatment options and improved outcomes. According to Dr. Robert McKenna, “lung screening has been proven to make a difference.” Dr. McKenna is an internationally renowned thoracic surgeon who has dedicated over 2 decades in General Thoracic surgery research and clinical care. He has produced more than 250 peer-reviewed publications about many different areas of Thoracic Surgery and 2 textbooks in Thoracic Surgery. His book, the Atlas of Minimally Invasive Thoracic Surgery, is a landmark publication in the field of video-assisted thoracic surgery.

Who should be screened for lung cancer?

If you are between 50-75 years old, this age range has the highest risk of developing cancer in the lung. Our program only screens people aged 50-77, with people between the ages of 50 to 60 years being in the most optimal age range for earliest detection. Those eligible for this screening program are current smokers or would have quit smoking within the past 15 years. In addition, the amount of smoking is also important for this screening program, having smoked for at least 20-pack years with no current symptoms of lung cancer.

20-pack years based on smoking one pack of cigarettes per day

If you are a current smoker or quit within the past 15 years, having at least 20-pack years, you are at highest risk.

How do I get screened?

Screening can be arranged with just a phone call. We can help you determine if you qualify as a former or current smoker. Our Nurse Navigator, Sara Belton, Ph.D., will provide additional information and determine if you qualify for the screening program. If you qualify, an appointment will be scheduled for an imaging scan.  One or more physicians will review your scan and will discuss the results of their findings and provide additional information.  Our Nurse Navigator is ready to guide you through the entire process and arrange any follow-up that is needed.