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About the Minimally Invasive Thoracic Surgery
Department

Our Department Specializes in providing Advanced Surgical Solutions for Thoracic conditions using Minimally Invasive Techniques. We are dedicated to Delivering High-Quality Care, Reducing Patient Discomfort, Minimizing Scarring, and Promoting Faster Recovery Times. Our Team of Experienced Thoracic Surgeons Utilizes State-of-the-Art Technology and Innovative Approaches to provide optimal outcomes for our patients.

 

 

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Reduced Trauma and Faster Recovery

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Improved Surgical Precision and Visualization

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Lower Risk of Complications

Minimally Invasive Thoracic Surgery Services

Our Department Specializes in providing Advanced Surgical Solutions for Thoracic conditions using Minimally Invasive Techniques. We are dedicated to Delivering High-Quality Care, Reducing Patient Discomfort, Minimizing Scarring, and Promoting Faster Recovery Times.

Treatment and Procedure

The Department uses minimally invasive surgical technique called Video-Assisted Thoracoscopic Surgery (VATS) for performing surgery in the chest area through small incisions. This avoids making large cuts or incisions in the body, and does not require spreading apart of the ribs as done with open surgeries. Surgeons use a camera and specialized instruments to get to the lung through small incisions in between the ribs for the surgery. VATS technique demands great deal of skill and it becomes that more important that the surgeon doing this procedure is experienced and renowned in this field.

Thoracic Procedures are specifically targeted towards Lung Cancer, Emphysema, Broncho Pleural Fistula, Bullectomies, Unilateral and Bilateral Bronchiectasis, Non Resolving Pneumonia, Decortication, Pleurectomy, Lung Biopsy in the treatment of Interstitial Lung Disease (ILD), Esophageal disorders and Chest Trauma. Other common procedures include palliative surgery for effusion from any cause - Liver Cirrhosis, Chylothorax, Breast, GI and Lung Malignancy, Curative Surgeries - (Hemoptysis, Cavity, Abscess, MDRTB, Aspergilloma). Excision of all types of Mediastinal Tumours and Surgery for Myasthenia Gravis.

Video-Assisted Thoracic Surgery (VATS) is frequently used by doctors to treat early stage of Lung Cancers. The surgery is done under general anesthesia with a breathing tube placed into the airway for lungs to be separately inflated during the surgery. During the surgical process, small incisions an inch wide between the ribs is made to see the entire chest cavity without having to open up the chest or spread the ribs. Small tube called a thoracoscope is inserted through these incisions between the ribs to remove the lung tissue with specialized instruments. At the end of the surgery, a chest tube is retained through one of the small incisions to drain extra fluid or air leaking into the chest and help lungs to function normally. This tube remains in place for a few days and is typically removed at the bedside before you go home. Recovery time is relatively short compared to open surgery. Most patients regain their strength, energy and breathing in two to three weeks. The advantages of Video-Assisted Thoracic Surgery (VATS) are faster recovery, fewer complications, shorter stay at hospital, less pain, decreased need of medication, less blood loss and no operational trauma with ribs. Every patient who under goes this VATS surgery may have different surgical approach depending upon the a number of factors like health history and the type of lung cancer etc. Surgeons evaluate each patient for minimally invasive thoracic surgery on a case by case basis such as physical condition, medical history and anatomy. Talk to Dr Nasser Yusuf to know more about Video-Assisted Thoracoscopic Surgery (VATS) and if it is right for you.

Emphysema is a condition of lungs which results in shortness of breath due to damaged air sacs of lungs. The symptoms of emphysema are frequent coughing, cough that produces a lot of mucus, shortness of breath during physical activity, whistling sound while breathing and tightness in chest. Emphysema has four stages and diagnosing the diesease early can help relieve symptoms and slow the progression of the disease. Treatment options with medications include bronchodilator Medications, steroids and antibiotics. Vaccines and Oxygen and Protien therapy helps in the management of the breathing process. For some patients surgical options are Lung Transplantation and lung volume reduction surgery, during which small wedges of damaged lung tissue are removed. This procedure is done by Video-Assisted Thoracoscopic Surgery (VATS) technique.

A bronchopleural fistula is a serious condition caused by lung cancer surgery, pneumonectomy (removal of lung), chemotherapy, radiation, or an infection. Air that is breathed into the lungs leaks through the passageway and enter the membranes that line the lungs called pleural cavity resulting in bronchopleural Fistula. Bronchopleural Fistula is diagnosed by CT scan of the chest to reveal increased air or fluid or pus in the pleural cavity. Treatment often involves in 3 steps. The first step is to drain the fluid that has accumulated in the pleural cavity due to the fistula. The second step is repairing the fistula through surgery, or endoscopically through a bronchoscopy tube which is safer and effective. And the third step is to get rid of pleural cavity so that fluid can no longer accumulate.

Bullectomies is a minimally invasive surgical process that removes bullae, an air space in the lung measuring more than 1 cm. Lungs is made up of collection of small air sacs, which helps in the transfer of oxygen into the blood stream. When these small air sacs in the lungs are damaged, they form to take up a large space called bulle, which doesnt have the capacity to absorb oxygen into the blood. Bullae are normally formed as a result from chronic obstructive pulmonary disease (COPD) commonly caused by smoking or long-term exposure to gas fumes. Most common symptoms of Chronic Obstructive Pulmonary Disease (COPD) are wheezing, tightness in the chest, frequent coughing up of mucus, lip or fingertip blueness, feeling tired and swelling of feet, leg, and ankle. Preparation and Treatment: A patient who under goes a host of physical tests to make sure that the patient is in good health for the procedure. This includes X-Ray, CT Scan and Angiography. Bullectomy is performed with general anesthesia. During the Video-Assisted Thoracoscopy (VATS) small incisions an inch wide between the ribs is made to see the entire chest cavity without having to open up the chest or spread the ribs. Small tube called a thoracoscope is inserted through these incisions between the ribs to remove the bullae and other affected parts of your lung and the surgeon closes the cuts with sutures. At the end of the surgery, a chest tube is retained through one of the small incisions to drain extra fluid or air leaking into the chest and help lungs to function normally. This tube remains in place for a few days and is typically removed at the bedside before you go home. Recovery time is relatively short compared to open surgery. Most patients regain their strength, energy and breathing in two to three weeks.

Non resolving Pneumonia (NRP) is an acute pulmonary infection that does not improve or worsens after the treatment with antibiotic therapy for a minimum of 10 days or radiographic opacities fail to resolve within 12 weeks. Non Resolving Pneumonia is of two causes Infectious Causes and Non Infectious Causes. Tuberculosis and fungal infections are usually the cause of Infectious causes with non resolving pneumonia. Non Infectiouos causes includes neoplastic lesions, pulmonary oedema, pulmonary embolism, drug-induced pneumonitis, diffuse alveolar haemorrhage syndromes, cryptogenic organising pneumonia and acute eosinophilic pneumonia. A patient with Non Resolving Pneumonia under goes physical tests X-Ray, CT Scan and CT Angiography. With fiber-optic bronchoscopy (FOB) more than half of the cases of persistent pulmonary opacity is diagnosed. It allows direct visualization of affected area and the direct obtaining of samples for treatment procedures.

Video-Assisted Thoracoscopic Decortication is a surgical procedure that remove all the fibrinous peel and necrotic tissue in the lung, chest wall, and diaphragm. The goal of decortication is to allow the lung to expand and deflate and function normally. The procedure is usually performed when the lung is covered by a thick, inelastic pleural peel which restricts lung expansion.

Pleurectomy is a minimally invasive surgery in which part of pleural lining around the lungs as well as other diseased tissues are removed. This procedure helps to prevent fluid from collecting in the affected area and is used for the treatment such as mesothelioma, a pleural mesothelial cancer, persistent or recurrent pleural fluid accumulation and malignant pleural fluid accumulation. Pleurectomy is done under general anesthesia. During the procedure, an incision is made along the back and parallel to the lungs (thoracotomy). After gaining access to the chest, the surgeon then carefully peels away and removes the layers of pleura. After the surgery, drainage tubes are placed to drain extra fluid, till the bleeding and discharge are small. The incision is then closed, often with sutures that will dissolve on their own. During the recovery period, respiratory therapy is administered to help patients to breathe deeply and get out of bed quickly to lower their risk of pneumonia, blood clots, and other complications. Pulmonary rehabilitation may be recommended down the line as well to improve breathing. Sometimes, pleurectomy greatly improve quality of life for people living with mesothelioma or a malignant pleural effusion.

Interstitial lung disease is caused by long-term exposure to asbestos, coal dust or rheumatoid arthritis. It is another term for pulmonary fibrosis, which is scarring and inflamation of tissues that surrounds the lung's air sacs, blood vessels and airways. This scarring and inflamation makes the lung tissue stiff, resulting in breathing difficulty. Symptoms of Interstitial Lung Disease include dry cough, shortness of breath, extreme tiredness and weakness, unexplained weight loss, mild pain in the chest and bleeding in the lungs. Video-Assisted Thoracoscopic (VATS) biopsy is considered as the gold standard for the treatment of Interstitial Lung Disease (ILD). VATS lung biopsy can be performed under general anesthesia.

Video-Assisted Thoracoscopic Surgery (VATS) has revolutionized the treatment of benign esophageal disorders such as asesophageal cancer, achalasia and Gastroesophageal Reflux Disease (GERD). Advantages of Video-Assisted Thoracoscopic Surgery (VATS) is shorter hospital stay, less postoperative discomfort, and much faster recovery time than with open surgery. Video-Assisted Thoracoscopy (VATS) is being used in many centers for the thoracic mobilization of the esophagus, reducing the size of the chest incision. In addition, laparoscopy can be used to mobilize the gastric conduit in the abdomen, reducing abdominal incision size as well.

Video-Assisted Thoracoscopic Surgery (VATS) is widely used to treat patients chest trauma from simple rib fractures, heart and lungs. VATS can often provide greater visualisation of the intra-thoracic structures, whilst limiting the burden of injury to smaller non-rib spreading incisions. VATS is used as a diagnostic tool too, to identify the extend of the injuries whilst also allowing for treatment. This decreases the rate of post-operative complications and a shorter length of inpatient stay. The benefits of VATS is decreased pain, pulmonary complications, prolonged air leak, arrhythmias, hospital stay, and post-operative quality of life are all improved by VATS surgery. The benefits of decreased pain, pulmonary complications, hospital stay and quality of life have been translated into the use of VATS in the trauma settings. Other common procedures include palliative surgery for effusion from any cause - Liver Cirrhosis, Chylothorax, Breast, GI and Lung Malignancy, Curative Surgeries - (Hemoptysis, Cavity, Abscess, MDRTB, Aspergilloma). Excision of all types of Mediastinal Tumours and Surgery for Myasthenia Gravis.

Mediastinoscopy is used to diagnose lymph nodes and masses in the entire Mediastinum (Central portion of Chest) with 100% accuracy. Useful in Lymphoma, Sarcoidosis, Hypersensitivity Pneumonitis, esophagus cancer, tumor of the thymus gland and Staging of Lung Cancer. The procedure is done uder general anesthesia. A thin, flexible tube with a light, small video camera and cutting tool on the end is put through a small cut made behind the breastbone and between the lungs known as mediastinum. The procedure usually takes about 60 minutes, but it might take longer, depending upon the procedure.

Surgery for Empyema, Congenital Cystic Adenamatoid Malformation, Congenital Lobar Emphysema, Foreign body removal. etc are routinely performed. Video-Assisted Thoracoscopic Surgery (VATS) technique is used more in pediatric thoracic procedures in children with childhood mediastinal tumors. Surgeons are able to explore and reach great vessels and other vital structures without major cuts or incisions. The safety and feasibility of this technique has been described for a wide range of procedures like pediatric empyema, Congenital Cystic Adenamatoid Malformation, Congenital Lobar Emphysema and Foreign body removal. Surgery is performed in an operating room and patients must be under general anesthesia. Video-Assisted Thoracoscopic Surgery (VATS) helps to avoid the more invasive, traditional thoracotomy or sternotomy, diminishes the patient’s pain and trauma to the body, and significantly reduces the hospital stay.

Rigid as well as fiber-optic Bronchoscopy along with Rigid Oesophagoscopy, are also available. Facility for AFB Culture and Drug Sensitivity Testing especially in MDRTB and Frozen Section are available which ensures immediate diagnosis and appropriate treatment. The Department is supported by an expert team of Consultants in Surgery, Pulmonology, Cardiology, Anesthesia, Medicine, Physiotherapy, Respiratiory Therapy, Microbiology, Pathology and Psychology. An active patient support group allays the fears and doubts in the minds of patients. Smooth running of the Department is ensured by the Patient Co-ordinator. Thus we are able to provide services on par with the best centers in the world.

Thoracic Procedures are specifically targeted towards Lung Cancer, Emphysema, Broncho Pleural Fistula, Bullectomies, Unilateral and Bilateral Bronchiectasis, Non Resolving Pneumonia, Decortication, Pleurectomy, Lung Biopsy in the treatment of Interstitial Lung Disease (ILD), Esophageal disorders and Chest Trauma. Other common procedures include palliative surgery for effusion from any cause - Liver Cirrhosis, Chylothorax, Breast, GI and Lung Malignancy, Curative Surgeries - (Hemoptysis, Cavity, Abscess, MDRTB, Aspergilloma). Excision of all types of Mediastinal Tumours and Surgery for Myasthenia Gravis.

Video-Assisted Thoracic Surgery (VATS) is frequently used by doctors to treat early stage Lung Cancers. The surgery is done under general anesthesia with a breathing tube placed into the airway for lungs to be separately inflated during the surgery. During the surgical process, small incisions an inch wide between the ribs is made to see the entire chest cavity without having to open up the chest or spread the ribs. Small tube called a thoracoscope is inserted through these incisions between the ribs to remove the lung tissue with specialized instruments. At the end of the surgery, a chest tube is retained through one of the small incisions to drain extra fluid or air leaking into the chest and help lungs to function normally. This tube remains in place for a few days and is typically removed at the bedside before you go home. Recovery time is relatively short compared to open surgery. Most patients regain their strength, energy and breathing in two to three weeks.

Emphysema is a condition of lungs which results in shortness of breath due to damaged air sacs of lungs. The symptoms of emphysema are frequent coughing, cough that produces a lot of mucus, shortness of breath during physical activity, whistling sound while breathing and tightness in the chest. Emphysema has four stages and diagnosing the disease early can help relieve symptoms and slow the progression of the disease. Treatment options with medications include bronchodilator Medications, steroids and antibiotics. Vaccines and Oxygen and Protein therapy helps in the management of the breathing process. For some patients surgical options are Lung Transplantation and lung volume reduction surgery, during which small wedges of damaged lung tissue are removed. This procedure is done by Video-Assisted Thoracoscopic Surgery (VATS) technique.

A bronchopleural fistula is a serious condition caused by lung cancer surgery, pneumonectomy (removal of lung), chemotherapy, radiation, or an infection. Air that is breathed into the lungs leaks through the passageway and enters the membranes that line the lungs called pleural cavity resulting in bronchopleural Fistula. Bronchopleural Fistula is diagnosed by CT scan of the chest to reveal increased air or fluid or pus in the pleural cavity. Treatment often involves 3 steps. The first step is to drain the fluid that has accumulated in the pleural cavity due to the fistula. The second step is repairing the fistula through surgery, or endoscopically through a bronchoscopy tube which is safer and effective. And the third step is to get rid of the pleural cavity so that fluid can no longer accumulate.

Bullectomy is a minimally invasive surgical process that removes bullae, an air space in the lung measuring more than 1 cm. Lungs are made up of a collection of small air sacs, which helps in the transfer of oxygen into the bloodstream. When these small air sacs in the lungs are damaged, they form to take up a large space called bulle, which does not have the capacity to absorb oxygen into the blood. Bullae are normally formed as a result from chronic obstructive pulmonary disease (COPD) commonly caused by smoking or long-term exposure to gas fumes. Most common symptoms of Chronic Obstructive Pulmonary Disease (COPD) are wheezing, tightness in the chest, frequent coughing up of mucus, lip or fingertip blueness, feeling tired and swelling of feet, leg, and ankle.

Unilateral and Bilateral Bronchiectasis is a long-term condition where the airways of the lungs become widened abnormally and damaged, resulting in the build-up of excess mucus and making lungs more vulnerable to infection. These infections can cause pneumonia, tuberculosis, immune system problems and cystic fibrosis. The most common symptoms of bronchiectasis is persistent cough with sputum, chest pain, shortness of breath, thickening of skin under finger and toenails and feeling tired. There is no cure for bronchiectasis, but early and effective treatment can help to reduce complications, prevent infections, control secretions, relieve obstructions in the airway and stop the disease from progressing. Medications and physical therapy help to drain the mucus. In certain conditions, bronchiectasis affects only one lung or a limited area, or if damage is severe and there are frequent infections, surgery may be advised. A person with advanced bronchiectasis and cystic fibrosis lung transplantation is recommended through Video-Assisted Thoracoscopic Surgery (VATS).

Non resolving Pneumonia (NRP) is an acute pulmonary infection that does not improve or worsens after the treatment with antibiotic therapy for a minimum of 10 days or radiographic opacities fail to resolve within 12 weeks. Non Resolving Pneumonia is of two causes: Infectious Causes and Non Infectious Causes. Tuberculosis and fungal infections are usually the cause of Infectious causes with non resolving pneumonia. Non Infectious causes include neoplastic lesions, pulmonary oedema, pulmonary embolism, drug-induced pneumonitis, diffuse alveolar haemorrhage syndromes, cryptogenic organising pneumonia and acute eosinophilic pneumonia. A patient with Non Resolving Pneumonia undergoes physical tests, X-Ray, CT Scan and CT Angiography. With fiber-optic bronchoscopy (FOB) more than half of the cases of persistent pulmonary opacity are diagnosed. It allows direct visualization of affected areas and the direct obtaining of samples for treatment procedures.

Video-Assisted Thoracoscopic Decortication is a surgical procedure that removes all the fibrinous peel and necrotic tissue in the lung, chest wall, and diaphragm. The goal of decortication is to allow the lung to expand and deflate and function normally. The procedure is usually performed when the lung is covered by a thick, inelastic pleural peel which restricts lung expansion.

Pleurectomy is a minimally invasive surgery in which part of the pleural lining around the lungs as well as other diseased tissues are removed. This procedure helps to prevent fluid from collecting in the affected area and is used for the treatment such as mesothelioma, a pleural mesothelial cancer, persistent or recurrent pleural fluid accumulation and malignant pleural fluid accumulation. Pleurectomy is done under general anesthesia. During the procedure, an incision is made along the back and parallel to the lungs (thoracotomy). After gaining access to the chest, the surgeon then carefully peels away and removes the layers of pleura. After the surgery, drainage tubes are placed to drain extra fluid, till the bleeding and discharge are small. The incision is then closed, often with sutures that will dissolve on their own. During the recovery period, respiratory therapy is administered to help patients to breathe deeply and get out of bed quickly to lower their risk of pneumonia, blood clots, and other complications. Pulmonary rehabilitation may be recommended down the line as well to improve breathing. Sometimes, pleurectomy greatly improves quality of life for people living with mesothelioma or a malignant pleural effusion.

Interstitial Lung Disease is caused by long-term exposure to asbestos, coal dust or rheumatoid arthritis. It is another term for pulmonary fibrosis, which is scarring and inflammation of tissues that surrounds the lung's air sacs, blood vessels and airways. This scarring and inflammation makes the lung tissue stiff, resulting in breathing difficulty. Symptoms of Interstitial Lung Disease include dry cough, shortness of breath, extreme tiredness and weakness, unexplained weight loss, mild pain in the chest and bleeding in the lungs. Video-Assisted Thoracoscopic (VATS) biopsy is considered as the gold standard for the treatment of Interstitial Lung Disease (ILD). VATS lung biopsy can be performed under general anesthesia.

Video-Assisted Thoracoscopic Surgery (VATS) has revolutionized the treatment of benign esophageal disorders such as esophageal cancer, achalasia and Gastroesophageal Reflux Disease (GERD). Advantages of Video-Assisted Thoracoscopic Surgery (VATS) is shorter hospital stay, less postoperative discomfort, and much faster recovery time than with open surgery. Video-Assisted Thoracoscopy (VATS) is being used in many centers for the thoracic mobilization of the esophagus, reducing the size of the chest incision. In addition, laparoscopy can be used to mobilize the gastric conduit in the abdomen, reducing abdominal incision size as well.

Video-Assisted Thoracoscopic Surgery (VATS) is widely used to treat patients chest trauma from simple rib fractures, heart and lungs. VATS can often provide greater visualisation of the intra-thoracic structures, whilst limiting the burden of injury to smaller non-rib spreading incisions. VATS is used as a diagnostic tool too, to identify the extend of the injuries whilst also allowing for treatment. This decreases the rate of post-operative complications and a shorter length of inpatient stay. The benefits of VATS is decreased pain, pulmonary complications, prolonged air leak, arrhythmias, hospital stay, and post-operative quality of life are all improved by VATS surgery. The benefits of decreased pain, pulmonary complications, hospital stay and quality of life have been translated into the use of VATS in the trauma settings. Other common procedures include palliative surgery for effusion from any cause - Liver Cirrhosis, Chylothorax, Breast, GI and Lung Malignancy, Curative Surgeries - (Hemoptysis, Cavity, Abscess, MDRTB, Aspergilloma). Excision of all types of Mediastinal Tumours and Surgery for Myasthenia Gravis.

Mediastinoscopy is used to diagnose lymph nodes and masses in the entire Mediastinum (Central portion of Chest) with 100% accuracy. Useful in Lymphoma, Sarcoidosis, Hypersensitivity Pneumonitis, esophagus cancer, tumor of the thymus gland and Staging of Lung Cancer. The procedure is done uder general anesthesia. A thin, flexible tube with a light, small video camera and cutting tool on the end is put through a small cut made behind the breastbone and between the lungs known as mediastinum. The procedure usually takes about 60 minutes, but it might take longer, depending upon the procedure.

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Benefits include smaller incisions, less pain post-operatively, shorter hospital stays, quicker return to normal activities, and generally fewer complications and risks associated with large incisions.

While MITS is generally safer and less invasive, risks can include bleeding, infection, and complications related to anesthesia, similar to other surgical procedures. Specific risks may also depend on the patient's overall health and the exact nature of the surgery.
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