By Robert J. Caccavale, MD, FACS, FCCP,
and Jean-Philippe Bocage, MD, FACS, FCCP
Patients with lung cancer or other types of
thoracic ailments don’t have to endure the painful and long recovery time often
associated with a thoracotomy. A thoracotomy is a ten to 12 inch surgical
incision of the chest wall, typically made on the right or left side of the
chest between the ribs in order to access the heart or lungs during surgery.
This type of surgery usually involves breaking or removing one or more
ribs.
Somerset Medical Center offers a minimally
invasive method to diagnose or treat thoracic conditions: video-assisted
thoracic surgery (VATS). The procedure only requires four incisions, each
less than an inch wide. During the operation, two surgeons working together
insert a thin scope with a camera on its tip, called a thoracoscope, into the
incisions. The camera projects an image of the contents of the chest cavity onto
a video monitor. The enlarged, digital image allows the physicians to get a
better view to and allows them to work between the chest muscles and avoid
injury to the ribs and reduces trauma to the chest wall muscles. With
video-assistance, surgeons are able to remove pathologic tissue of the lung and
mediastimum and use a less invasive and traumatic surgery than was required in
the past. VATS can also be used to diagnose pneumonia infections, infections or
tumors of the chest wall, and treat collapsing lungs. Additional uses of VATS
are continuing to be developed. The entire procedure typically lasts less than a
half-hour, compared with an average of about two hours for a
thoractomy.
A thoracotomy or traditional chest surgery
often requires two months of healing and recovery. Conversely, almost all of our
VATS patients do not require intensive care, can walk the same day, leave the
medical center in about two days and can return to their normal routines in
about seven to ten days. With VATS, the risks of complication are less than
three percent, decreasing the chances for pneumonia, hypothermia and respiratory
distress.
All chest surgeries at Somerset Medical
Center are performed using the VATS technique, including intervention for
cancers, lung abnormalities, infections and other problems affecting the chest
cavity.
The most common thoracic conditions include
lung malignancies and abnormalities, inflammatory lesions, infections and
diseases of the mediastimum. Symptoms of a thoracic condition often include
chest pain, a heavy cough, shortness of breath, wheezing and fatigue. If these
symptoms persist for more than two weeks, see your physician. Your doctor may
schedule a chest X-ray or a CT scan of the chest.
Individuals with a greater risk of
developing a thoracic condition include people who smoke or are exposed to
second-hand smoke and those with a family or personal history of thoracic
ailments.
For a physician referral, call
800-443-4605.
Somerset Medical Center surgeons Drs.
Caccavale and Bocage were among the first in the world to perform Video-Assisted
Thoracic Surgery and have successfully performed more than 6,000 surgeries using
this technique.