Thoracic Surgery

Minimally invasive surgical solutions and innovative procedures, close to home

The thoracic surgery team, provides a comprehensive program for the surgical treatment of diseases of the lung and esophagus, trachea, mediastinum and chest wall. The thoracic care team specializes in treatment for lung cancer, esophageal cancer, hiatal and paraesophageal hernias, achalasia, thoracic outlet syndrome, myasthenia gravis, thymoma, primary pneumothorax and hyperhidrosis.

Using minimally invasive and robotic-assisted surgery patients may recover faster and with less pain. Using small incisions, this approach offers greater precision, reduces blood loss and creates a smaller area to heal.

Why Choose Us?

  • The thoracic care team provides you and your family with access to specialized expertise in minimally invasive robotic thoracic surgery and advanced airway surgery, close to home in the Mid-Hudson Valley.
  • Minimally invasive robotic surgery provides greater precision, reduces healing time and may allow a faster recovery.
  • Quality outcomes are critical to the success of the thoracic program. Our team voluntarily reports our outcomes to the Society of Thoracic Surgeons in order to critically assess our outcomes and benchmark against other top programs.

Conditions and Treatments*

Robotic-assisted thoracoscopic surgery (RATS) is a minimally invasive approach to thoracic surgery. The HQMP thoracic care team uses the da Vinci ® robotic-assisted surgical system. Compared to other surgical techniques, it provides a number of patient benefits, including:

  • Shorter hospital stays
  • Quicker recovery times
  • Less pain
  • Less blood loss

Lung Cancer

Esophageal Cancer

Mesothelioma

Thymoma

Tracheal Tumors

Benign Esophageal diseases:

  • Achalasia is a rare condition of the esophagus that is characterized by reduced esophageal motility and high resting pressure of the lower esophageal sphincter. Symptoms include:
    • Difficulty swallowing
    • Regurgitation of food
    • Chest pain
    • Bronchitis and pneumonia due to aspiration of food content into the respiratory system

Achalasia can be treated using a procedure called Heller myotomy. This surgical procedure is performed utilizing state-of-the-art robotic technology. Your doctor may also discuss with you a peroral endoscopic myotomy (POEM) procedure that involves esophageal and gastric myotomy conducted via an endoscope.

  • Gastroesophageal reflux disease (GERD) is a motility disorder of the gastrointestinal tract resulting in reflux of gastric contents into the esophagus. Treatment options include:
    • Nissen fundoplication is a laparoscopic procedure that involves wrapping part of the stomach (the fundus) around the esophagus to strengthen the lower esophageal sphincter and help prevent acid from backing up the esophagus.
    • Toupet fundoplication is similar to Nissen fundoplication, except Nissen fundoplication wraps the stomach a full 360 degrees around the esophagus, and Toupet fundoplication is a 270-degree wrap.
    • Belsey Mark IV repair is another fundoplication procedure that is done transthoracically (through the chest wall). This procedure may be useful for obese patients and may be combined with an esophageal lengthening procedure called Collis gastroplasty.
    • LINX® procedure is a minimally invasive procedure that provides an alternative to fundoplication. It involves the laparoscopic implantation of magnetic titanium beads around the lower esophageal sphincter. Magnetic attraction between the beads prevents the backward flow of stomach contents. Many patients are able to return to a regular diet and normal activities almost immediately following the procedure.
    • Transoral incisionless fundoplication (TIF) procedure is another minimally invasive procedure that does not involve entry into the abdominal cavity. The surgeon inserts a flexible endoscope orally into the stomach to recreate a valve between the esophagus and stomach.
  • Hiatal hernia/Paraesophageal Hernia
    Symptoms include:

    • Regurgitation
    • Difficulty swallowing
    • Bloating, breathlessness with meals
    • Early satiety (filling up quickly when eating)
    • Pain
    • Strangulation or incarceration

We collaborate with minimally invasive laparoscopic surgeons to repair large paraesophageal hernias in a minimally invasive fashion.

Other Conditions:

Hyperhidrosis (excessive sweating) that leads to emotional distress and significant social and work impairment. Your doctor may discuss an endoscopic thoracic sympathectomy (ETS) procedure if you are a candidate.

Pectus excavatum or funnel chest is the most common congenital chest wall deformity. This condition is a result of improper fusion of the ribs and the sternum during embryonic development and appears as a chest depression. Surgical options your doctor may discuss with you include:

  • Ravitch procedure is performed by your thoracic surgeon making an incision across the chest to reshape your rib cartilage and using a small bar to keep the sternum in its new position. The bar is usually removed in about 6–12 months.
  • NUSS procedure is a minimally invasive technique where bars are placed behind the sternum to push it back into place. The bars are then removed several years later.

Primary spontaneous pneumothorax (also known as a collapsed lung) is the collection of air in the pleural cavity leading to a separation of the pleural layers covering the lungs. This condition usually occurs in tall, young males. Symptoms include an acute shortness of breath and chest pain. Recurrent instances of spontaneous pneumothorax may be an indication for surgical treatment, such as minimally invasive video-assisted thoracoscopic surgery (VATS).

 

Mediastinum:

  • Myasthenia gravis is a chronic autoimmune neuromuscular disorder characterized by a weakness of the skeletal muscles most commonly involving the eyes, face and pharynx. Some treatments your doctor may discuss with you include:
      • Medications, plasmapheresis (plasma exchange) and intravenous immunoglobulins (IVIG) or immune proteins.
      • Surgical therapy including thymectomy (removal of the thymus gland). This is done using minimally invasive robotic technology via three small half-inch incisions.
  • Foregut duplication cysts are congenital malformations in the gastrointestinal (GI) tract or airway. They are usually asymptomatic but sometimes may compress surrounding structures leading to respiratory distress and difficulty with swallowing. Surgical removal may be performed using advanced robotic-assisted thoracoscopic surgery with the da Vinci® surgical system.
  • Neurogenic tumors are tumors of the mediastinum (They are commonly found in the posterior mediastinum (the region between the lungs and spine). Thoracic surgeons utilize minimally invasive robotic-assisted thoracoscopic surgery (RATS) with the da Vinci® surgical system to remove these tumors.
  • Thymoma is a rare tumor involving the thymus gland in the anterior mediastinum (the region between the lungs). Thymomas may be benign or malignant and are often associated with myasthenia gravis. Surgery is often the best choice for these rare tumors. In cases of large, invasive tumors, chemotherapy and radiotherapy may also be utilized. Surgical resection of the thymus is performed using robotic-assisted thoracoscopic surgery (RATS) with da Vinci® surgical system. See also myasthenia gravis.

* Disclaimer: The content contained on this website is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.