Minimally invasive and robotic thoracic surgery

Robotic thoracic surgery is a procedure in which the surgeon makes several tiny incisions between the ribs, then inserts small robotic arms and a small camera through the incisions. During the procedure, the surgeon sits at a computer console while the camera provides a 3-D view of the lungs or chest area magnified 10 times greater than a person's normal vision. The surgeon's hands control the robotic arms from the console, translating his or her larger hand movements into smaller, more precise movements. In addition, special tools attached to the robotic arms allow the surgeon cut, grasp and stitch.

There are multiple types of robotic thoracic surgery. We perform:

• Esophagectomy - Surgery to remove part or all of the esophagus, the tube that carries food from the throat to the stomach. The esophagus is then rebuilt from part of the stomach or large intestine. The procedure is mainly performed to treat esophageal cancer. Surgery to remove the lower esophagus may also be necessary to treat: 
  • Achalasia
  • Barrett’s esophagus
  • Severe trauma
• Laparoscopic Heller myotomy - A procedure for correcting achalasia, a disorder of the esophagus that gradually prevents a person from swallowing foods and liquids. As the muscles of the upper esophagus weaken, they become unable to move food from the esophagus down to the stomach, and at the same time, the lower esophageal muscle doesn’t totally relax, making it difficult for food to get into the stomach. A Heller myotomy weakens the muscles between the esophagus and the stomach, which helps the valve between them stay open.
• Lobectomy - A lobectomy, removal of a large piece of lung, is the most common treatment for lung cancer. For early-stage lung cancer, video-assisted thoracoscopic surgery (VATS) is a less invasive option than a traditional thoracotomy. During a VATS procedure, four small incisions are made in the chest (rather than opening up the ribs). The thoracic surgeon removes the tumor and any affected tissue through the incisions. In the case of early-stage cancer, the surgeon also may remove lymph nodes in the mid-chest area to make sure the cancer has not metastasized.
• Thymectomy - A type of surgical treatment for myasthenia gravis (MG), a neuromuscular disease. In MG, the immune system attacks the connections between muscles and nerves, which keeps muscles from receiving nerve signals telling them when to relax or contract. Muscles become weak, resulting in double vision or blurred vision, drooping eyelids, difficulty with speaking and swallowing, and/or weakness of the limbs. Video-assisted thymectomy surgery is performed through small incisions on the right or left side of the chest, into which narrow tubes with a light and camera at the end are inserted. Surgical instruments are passed through the tubes, and the surgeon performs the procedure while viewing the thymus on a monitor. In video-assisted thoracoscopic extended thymectomy (VATET), incisions are made on both sides of the chest and in the neck for more complete removal of the thymus.
• Repair of hiatal hernia - When the opening (hiatus) in the muscle between the abdomen and diaphragm is too large, some of the stomach can bulge up into the chest. Gastric acid from the stomach can then flow back into the esophagus, causing heartburn (gastroesophageal reflux disease, or GERD). Hiatal hernia surgery repairs the bulging of the stomach through the muscle. The procedure usually can be done laparoscopically, using very small incisions. During the procedure, the surgeon moves the stomach and lower esophagus back into the abdominal cavity, tightens the diaphragm and stitches the stomach in position. The upper part of the stomach (fundus) may be wrapped around the esophagus (fundoplication).
• Sympathectomy - Endoscopic thoracic sympathectomy (ETS) is surgery to treat hyperhidrosis, or excessive sweating (usually of the palms or face), if no other treatment has worked. Since the sympathetic nerves control sweating, the surgeon cuts the nerves to the affected area. The surgery is done through tiny incisions under one arm and a tiny camera on an endoscope (long, thin flexible tube) is inserted through one of the incisions and into the chest.
• Pneumonectomy (removal of a lung)
• Other less invasive procedures