Thoracic Surgery

No where in western India dedicated Thoracic surgery centre exists such as in SAL hospital, headed by surgeon with over twenty seven years of excellence in this field. The department can boast of almost every known surgical procedure in this field with good results.

Thoracic (Chest) Surgery includes Surgery of:

  • Lungs
  • Pleura-outer covering of lung
  • Mediastinum-space in the chest cage, not occupied by heart and lungs
  • Trachea-wind-pipe
  • Birth defects of and tumors of the chest wall
  • Chest injuries
  • Diaphragm-partition between chest and abdomen
  • Esophagus-food pipe

Lung Surgery


1.

Wedge resection
(segmentectomy). The surgeon removes a small wedge-shaped piece of lung that contains the lung cancer and a margin of healthy tissue around the cancer. This is likely to be done when your lung function would be decreased too much by removing a lobe of lung (lobectomy). The risk of lung cancer coming back (recurring) is higher with this method.
wedge-resection-segmentectomy
     

2.

Lobectomy.
The right lung has three lobes and the left lung has two lobes. A lobectomy removes the entire lobe of your lung that contains the cancer. Your lungs can function with the lobes that remain.
lobectomy
     

3.

Pneumonectomy. A pneumonectomy removes your entire lung that contains the lung cancer. A pneumonectomy is done only when needed, because it will greatly reduce your overall lung function.
pneumonectomy
     

4.

Sleeve Lobectomy A surgical procedure that removes a cancerous lobe of the lung along with part of the bronchus (air passage) that attaches to it. The remaining lobe(s) is then reconnected to the remaining segment of the bronchus. This procedure preserves part of a lung, and is an alternative to removing the lung as a whole (pneumonectomy).
sleeve-lobectomy
     
 
lung-surgery
  • Lung Tumors-cancerous & non cancerous
  • Tuberculosis
  • Lung Abscess-collection of pus within lung
  • Bronchiectasis-Dilatation & infection of airways
    within lung
  • Bullous disease-ballooning of lung
  • Fungal disease of lung
  • Foreign bodies in lung & airways
lung-surgery1
 
     
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Pleural Diseases

pleural-diseasesPleura is a ultra thin wall sac in which lung sits

  • Empyema-collection of pas
  • Pneumothorax-collection of air(at times life-threatening)
  • Removing air allows a collapsed lung to expand.
  • Collection of blood-Haemothorax
  • Tuberculosis-needing ‘decortications’
  • Collection of cancerous fluid within pleura

Mediastinum

  • Diseases related to thymus- tumors, myasthenia gravis
  • Diseases of lymph nodes
  • Various cancerous and non cancerous tumors

Trachea

  • Tracheal tumors & narrowing
  • Foreign bodies

Disease of the diaphragm

  • Birth defects of partition
  • Hiatus hernia

Disease of Esophagus

  • Cancer of esophagus
  • Narrowing of esophagus

Laser Lung Surgery

"SAL Hospital has always been the pioneer in bringing new technology in the healthcare industry for more than a decade. This time SAL hospital is pioneering in bringing Laser Assisted Metastatectomy Pulmonale (LAMP) for the First time in Asia."

 

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  • What is pulmonary metastatectomy?
  • Pulmonary metastasis, a devastating diagnosis for patient and family, means spread for cancer anywhere in the body to lungs. Pulmonary metastatectomy means removal of cancer from the lungs. Today, patients with spread of cancer to lungs are considered ‘incurable’. Their overall 5-year survival is just 3 to 5%. In selected patients, pulmonary metastatectomy improves this figure up to 30 to 40%.
  • Why this operation is not very popular?
  • Present techniques of pulmonary metastatectomy are not perfect. They involve sacrifice of healthy lung tissue to a great extent. Patient needs prolonged stay in hospital. If the spread is at many places in one lung or in both lungs, this operation is not possible with present techniques.
  • What is the role of laser in this operation?
  • The modern 1318-nm laser is a perfect answer to all the drawbacks of current techniques. Using special lung laser, multiple nodules of spread from one or both lungs can be removed. There is minimum loss of healthy lung tissue. Even cancer nodules situated deep within lung can be removed with ease and safety. It is done through a very small incision below the armpit. Patient stays in hospital for just 2 to 4 days. If necessary, the operation can be repeated at a later date if patient is unfortunate to have further spread of disease.
  • Which patients are suitable for laser surgery?
  • Patient’s primary cancer, which may be anywhere in body, completely under control. Lung should be the only site of cancer spread. Spread in lung should be completely removable and patient should be fit to undergo the procedure.
  • How long does the operation last?
  • About 1 to 2 hours depending on number of cancer nodules in lungs.
  • What is the risk to life?
  • About 1%.
  • Does the patient need blood transfusion or postoperative ventilator treatment?
  • Most often, no.
  • Can this operation not be done without surgery?
  • No, finger palpation during open surgery detects more number of lung nodules than reported on the best CT scan. This is not possible in endoscopic surgery.
  • Does this operation cure cancer?
  • No.
  • What are the drawbacks of this operation?
  • It cannot help all patients with spread to lungs. It is not a substitute for standard methods of treating cancer. The technology is expensive but now it is available at doorsteps.
  • Who carries out this operation?
  • Dr Tushar Shah, a senior Cardio-Thoracic surgeon and consultant at SAL hospital performs this operation. He is specially trained for it in Germany.
  • How old is the laser technology for lung surgery?
  • It is there since 15 years but has picked up rapidly since last 5 years. One centre in Germany, which draws patients from all over the world, has performed more than 1000 operations with this technology. The first lung laser in U.K was installed in June, 2010.
  • Is SAL hospital the first in India to carry out Laser Assisted Pulmonary Metastatectomy?
  • Yes, SAL hospital is the first not only in India but also in Asia to acquire the latest 1318-nm lung laser. We successfully carried out one such operation on 16/04/2011. Patient was discharged within less than 48 hours.
  • What is the final word?
  • So called ‘incurable’ patients can be offered one more option, one more ray of life. The surgery is yet another weapon in our multi-modality fight against cancer.
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