A Thoracotomy is most often performed to remove lung cancer. It involves making an incision between ribs to gain access to the lung cavity. Removal of a lung tumor may require a wedge resection, or lobectomy (removal of a lung lobe) or pneumonectomy (removal of the entire lung). At the time of thoracotomy for cancer, sampling of lymph nodes is done for tumor staging and to assess the need for additional treatment.
Video Assisted Thoracoscopy (VATS)
VATS is a minimally invasive alternative for a variety of thoracic conditions. Video Assisted Thoracic Surgery can be used for either diagnostic or therapeutic purposes. Small incisions are used to allow insertion of a videoscope and special instrumentation. It reduces pain after surgery and leads to more rapid recovery. In some cases, VATS has enhanced complex open surgical techniques. Prior to surgery, patients are evaluated to determine appropriate treatment options for their condition. Thoracoscopy is often used for pleural biopsy (removal of pleural tissue for examination) to differentiate between benign and malignant disease.
Mediastinoscopy is a surgical procedure that allows physicians to view and biopsy areas in the mediastinum (the central part of the chest). The organs in the mediastinum include the heart and its vessels, the lymph nodes, trachea, esophagus, and thymus. Mediastinoscopy is most commonly used to biopsy enlarged lymph nodes or tumor in and around the trachea (windpipe). It is done through a small incision just above the sternal notch, under general anesthesia as an outpatient procedure.
Surgical Treatment of Pleural Effusion & Empyema
Pleural effusions (fluid collections in the chest) may be diagnosed and/or drained with thoracentesis (drainage by a small catheter) or chest tube insertion. Empyema (infectious collections around the lung) may require surgical stripping out of the inflamed, scarred tissues (decortication).