Minimally Invasive Surgery for Lung & Pleural Conditions

University of Chicago thoracic surgeons perform a variety of minimally invasive procedures for conditions of the lung, pleura and mediastinum. Compared to surgery performed through a long, open-chest incision, minimally invasive lung surgery provides several benefits for patients, including the following:

• Faster recovery and return to normal activities
• Shorter hospital stay
• Less pain
• Little scarring
• Minimal blood loss
• No cutting of the ribs or breastbone (sternum)

Our team includes leaders in minimally invasive thoracic surgery (MITS), which can be performed using video assistance or robotic assistance:

• Video-assisted thoracic surgery (VATS) is a technique that involves insertion of a long, thin tube (called a thoracoscope) with a camera attached to it through a small incision, or port. The thoracoscope allows the surgeon to examine inside the chest cavity and to remove tissue using thin instruments inserted through one or two additional ports. For more extensive operations such as lung resection for cancer, an additional incision measuring about 6 centimeters is made for the removal of the lung tissue. About one-third of our lung resection operations are performed using the VATS method.
• Robotic thoracic surgery is an approach that is performed with the use of the da Vinci Surgical System, a sophisticated robotic device that, like VATS, gives the surgeon access inside the chest cavity through tiny incisions. The surgeon controls the robot's movements from a nearby console in the operating room. The use of this technique is evaluated on a case-by-case basis and may be used when VATS is not an option for visualization or accessibility reasons.

Our surgeons choose the best approach for each patient, taking into account many factors, such as the patient's particular condition, medical history and anatomy.

University of Chicago thoracic surgeons offer minimally invasive diagnostic and treatment options for the following conditions, and more:

Lung Cancer

Barbara Arvia had VATS surgery for early-stage lung cancer. »Read her story

University of Chicago thoracic surgeons use either VATS, robotic or open techniques to diagnose, stage and treat lung cancer. Our surgeons regularly use minimally invasive techniques to remove nodules and tumors for an accurate and swift diagnosis. Chest lymph nodes are also biopsied to determine the stage of the cancer. If cancer is confirmed, the surgeon may perform one of the following procedures:

• Wedge resection: Removal of the tumor and tissue surrounding the cancer.
• Segmental resection: Removal of the tumor and surrounding anatomic structures consistent with a more complete cancer operation. This may be appropriate for very small, peripheral tumors.
• Lobectomy: Removal of the entire lobe of the lung that contains the cancerous tissue. This is the standard operation for most lung cancers.

View lung cancer care video presentations by University of Chicago thoracic surgeon Mark Ferguson, MD and other UCMC experts.

In many cases, VATS surgery enables patients to be discharged the day following the operation, making the duration of the hospital stay much shorter than the traditional three to six days necessary after an open chest operation.

Our thoracic surgeons work closely with other University of Chicago cancer experts to provide the full range of treatment options for lung cancer. »Learn more about our lung cancer care services

Pleural Effusion

Pleural effusion is the presence of excess fluid in the pleural space, the space between the lungs and the chest wall. VATS surgery may be performed to remedy this problem by removing restricting tissue around the lung, applying medicine to reduce fluid accumulation, or inserting a temporary drainage tube, substantially reducing symptoms associated with the fluid collection.

Pneumothorax

Pneumothorax occurs when air leaks into the space between the lungs and chest wall, causing part or all of a lung to collapse. VATS surgery is typically performed to prevent recurrence of the problem, or when prior treatment with a chest tube is unsuccessful. Any abnormal blisters on the surface of the lung that contribute to air leakage are removed, and medicine is applied to the pleural surfaces to reduce the risk of future lung collapse.

Thymoma & Other Tumors of the Thymus

Thymoma is a tumor of the thymus, a small gland that is located in the upper chest, behind the sternum (breastbone). Both benign and malignant tumors can occur in the thymus, and are sometimes found in people diagnosed with myasthenia gravis. At the University of Chicago Medical Center, thymectomy, or removal of the thymus, sometimes can be performed through one or more small incisions such as transcervical or VATS approaches, rather than a long chest incision.

Other Conditions

In addition to the conditions listed above, University of Chicago thoracic surgeons perform minimally invasive surgery for the following conditions:

• Achalasia, a disorder of the esophagus that makes it difficult to swallow food.
• Barrett's esophagus, a precancerous condition that develops as a result of gastroesphageal reflux disease.
• Esophageal cancer, including esophageal adenocarcinoma and squamous cell carcinoma of the esophagus
• Gastroesophageal reflux disease (GERD), a condition when a higher-than-normal amount of gastric juice refluxes from the stomach back into the esophagus.
• Hyperhidrosis, or excessive sweating. Using endoscopic techniques, our surgeons can destroy or remove the sympathetic nerve, which greatly reduces symptoms.
• Myasthenia gravis, a disorder of the immune system, resulting in severe muscle weakness and fatigue. Removal of the thymus gland, which is located in the neck and extends into the chest, has been shown to be an effective method to reduce symptoms in people with this condition.