Thoracic Surgery Treatments at Mount Sinai
The thoracic surgeons at Mount Sinai Hospital are pioneers of the latest surgical techniques for the treatment of lung cancer, esophageal cancer, thymoma and excessive sweating (hyperhidrosis.These include:
Lung Cancer and Mesothelioma Treatments
- VATS Lobectomy: VATS stands for Video-Assisted Thoracic Surgery lobectomy and is a form of minimally invasive surgery. A lobectomy is the surgical removal of a section of lung and is the most common surgery performed to treat lung cancer. A traditional lobectomy is performed with a thoracotomy, where an incision is made between the ribs and the ribs are spread apart so the surgeon can see into the chest. A VATS lobectomy is far less invasive than a standard thoracotomy. A few small incisions replace the large one of the thoracotomy and the ribs do not need to be spread apart, thereby reducing recovery time and increasing overall quality of life for the patient.
Raja Flores, MD, Chairman of the Department of Thoracic Surgery at Mount Sinai, established VATS lobectomy as the gold standard in the surgical treatment of lung cancer. Dr. Flores is one of the most experienced VATS lobectomy surgeons worldwide with more than 15 years experience and is continually advancing the field through research and clinical practice.
- Extrapleural pneumonectomy: During this surgical procedure, the surgeon removes the diseased lung, the parietal pleura (the lining of the chest wall), part of the pericardium (the lining covering the heart), and part of the diaphragm. It is a complex operation, performed on patients with early stage, localized (not metastatic) to treat malignant mesothelioma.
- Pleurectomy/decortications: This lung-sparing operation is used to treat mesothelioma and involves the removal of the parietal pleura (a parietal pleurectomy), the visceral pleura (decortication – the lining of the lung), part of the pericardium, and part of the diaphragm in order to free the underlying lung so that it can expand and fill the pleural cavity.
- Minimally Invasive Esophagectomy: The minimally invasive esophagectomy (MIE) procedure was developed in the past decade, but is only performed at several specialized centers in the nation. The procedure involves laparoscopy and video-assisted thoracoscopic surgery (VATS) to remove the esophagus and replace it with the stomach.
- Chemotherapy and Radiation: Chemotherapy is the use of drugs to kill cancer cells, typically by inhibiting mitosis of the cancerous cells. Radiation therapy is the use of radiation, such as high-energy x-rays, to kill cancer cells. The two methods are usually administered simultaneously to treat esophageal cancer.
- Thymectomy: This surgery involves the removal of the thymus gland to treat myasthenia gravis. The standard approach is a sternotomy, which involves an incision through the breastbone. VATS thymectomy is a minimally invasive approach that involves small incisions into the chest and removal of the thymus with the aid of a camera.
Excessive Sweating (Hyperhidrosis)
- Endoscopic Thoracic Sympathectomy (ETS): Bilateral ETS permanently treats excessive sweating of the hands and axilla (armpit), a condition formally called ‘hyperhidrosis’. Using small instruments, the surgeon inserts a small telescope attached to a camera and a dissection device into the chest cavity and cuts the sympathetic nerve. ETS is not only permanent, but also very cost effective. Many patients opt for this procedure if other conservative treatments have not yielded desired results or because it is a permanent solution.