Thoracic Surgeon

What is a Thoracic Surgeon?

The statistics of WebMD highlighted the dreadful facts about heart disease that a person got a heart attack every 40 seconds. As per the recent figures of 2022 (WebMD), heart disease is claimed as the leading cause of death in the U.S. that kills 1 person every 36 seconds. Heart disease is followed up with ‘lung cancer’ which also presented the shocking fact that cancer is the 3rd most common and the leading cause of cancer death in both men and women.

The said statistics highlighted the importance of cardiothoracic surgeons, general thoracic surgeons, and congenital heart surgeons, specialized in their fields, well trained, and equipped with the latest technology and required equipment. Unfortunately, developing and underdeveloped countries are deprived of specialized surgeons, their training opportunities, research culture, and advanced technology that create a drastic impact on the lives of their people. To get the treatment facilities of thoracic and cardiothoracic surgeons, people travel to medically developed countries especially the U.S. which creates a burden on the U.S. medical system and their team. 

Who is a Thoracic Surgeon?

A thoracic surgeon is a medical expert who performs cardiothoracic surgery in collaboration with cardiac, or heart specialists. They operate the heart, lungs, esophagus, and major blood vessels inside the chest, along with the bony structures and tissues of the chest cavity.  More specifically, thoracic surgeon deals with the following diseases and injuries inside the chest;

  • Heart lesions such as coronary artery disease and valve disorders
  • Heart transplants
  • Lung cancer
  • Benign lung diseases and lung tumors
  • Chest disease
  • Esophageal cancer
  • Gastroesophageal reflux disease (GERD)
  • Emphysema
  • Lung transplants
  • Mesothelioma
  • Tracheal resection 

Required Education and Training for Thoracic Surgeon:

A thoracic surgeon must hold a 4-years undergraduate medical degree along with a 5-years general surgery residence. The residency requirement may vary according to the selection of sub-specialty such as;

  • General thoracic surgery
  • Congenital or pediatric heart surgery
  • Adult cardiac surgery

The range of residency requirements depends upon the medical school and residency program. Moreover, a thoracic surgeon requires 6-8 years of specialty training to get a surgery certification. 

When do you need to Visit Thoracic Surgeon?

An individual is unable to identify the need to visit a thoracic surgeon. Most of the time, your regular physician or doctor recommend you to consult with the thoracic surgeon in case of following illness or diseases that require chest surgery;

  • Chest pain (moves into arms, shoulders, neck, and jaw)
  • Dizziness 
  • Feeling of fast heartbeat, fluttering, or pounding heart
  • Frequent fainting spells caused by an irregular heartbeat, seizures, low blood sugar, and nerve problems
  • Breathing difficulty
  • Lung cancer
  • Esophageal stricture (severe heartburn)

What to expect from a Thoracic Surgeon? 

When you visit a thoracic surgeon, he/she will probably perform the following activities to diagnose the illness, its cause, and required treatment that includes;

  • Review of medical records and medical history. 
  • Perform a physical exam to examine the blood pressure, heart, and lungs health. 
  • Conduct necessary diagnostic tests such as X-rays, EKG, or echocardiogram.
  • Recommend required treatment to heal the illness.
  • Discussion about the need and urgency of surgery, related benefits, and potential risks associated with it. 
  • Guidance about the other possible treatment options.
  • Instructions about pre-surgery, during surgery, and post-surgery activities.

Thoracic Surgery:

It includes the treatment of all chest organs such as the heart, lungs, esophagus, and trachea. It is quite a satisfactory fact that technological advancement enhances the safety and success rate of surgical operations. Resultantly, people across the world show confidence in thoracic surgeon expertise and equipment for lung cancer surgeries, heart transplants, coronary artery bypass surgeries, and anti-reflux surgeries.  Thoracic surgery is also known as chest surgery that can be performed to diagnose or treat lungs affected by cancer, trauma, or pulmonary disease. 

Who is Eligible for Thoracic Surgery?

All patients are not eligible for thoracic surgery, the surgeon is the final authority to decide whether to perform surgery or go for medications to control the symptoms. It depends upon the patient’s specific health condition, medical history, and anatomy. 

Types of Thoracic Surgery procedures:

The surgery can be performed by either minimally invasive techniques or a thoracotomy (an open surgical procedure). The detail of both procedures is given as below;

  • Minimally Invasive Technique: It is a method of performing chest surgery by making a small incision in the chest instead of large cuts that do not require spreading apart of the ribs. In this procedure, the surgeon uses a camera and instruments to approach the lung through small incisions in between the ribs.

Minimally invasive techniques include the following two different options to treat the illness that occurs in chest organs;

  • Video-assisted thoracoscopy surgery (VATS): In this procedure, the surgeon makes only three small incisions in the chest. Among one of the incisions, a small tube ‘thoracoscope’ is inserted between the ribs to see the entire chest cavity by using a camera that is attached to one of the thoracoscopies. While other two incisions are used to remove the lung tissue with specially designed instruments. 
  • Robotic-assisted surgery: In this technique, a surgeon will sit at a console next to the patient in the operating room and the whole surgery is performed by the robotic surgical system. The surgeon only controls this system. Similar to the VATS, small incisions are made, from which one incision is used to insert a small 3D high-definition camera inside of the chest cavity, and wristed robotic instruments are inserted through the other small incisions made in between the ribs. The surgeon removes lung tissue by using wristed robotic instruments without making larger incisions to open up the chest or spread the ribs.

Thoracotomy:

This option is suitable when a surgeon intends to get a better view of the lungs or inner chest cavity to remove the entire lung or a portion of the lung. In thoracotomy, a surgeon can adopt any one of the following procedures;

  • Wedge resection is used to remove the tumor and tissue surrounding cancer.
  • Anatomical segmental resection helps in the removal of the tumor, the blood vessels, the lymphatic drainage, and the cancerous lung segment.
  • Lobectomy is beneficial to remove the entire lobe of the cancerous lung. 
  • Pneumonectomy can also help in removing the whole lung with the lymph nodes.
  • While Pleurectomy is used to remove the inner lining of the chest cavity. 

Benefits of Thoracic Surgery:

Thoracic surgery presented multiple benefits for the patients as compared to open chest surgery. Following are the most significant benefits of thoracic surgery;

  • Faster recovery 
  • Less complications
  • Shorter hospital stay
  • Less pain 
  • Smaller scars
  • Minimum blood loss
  • No cutting of the ribs or breastbone

The potential risk associated with Thoracic Surgery:

Likewise other surgical procedures, thoracic surgery may bear the following potential risks associated with it;

  • Infection
  • Bleeding
  • Abnormal heartbeat
  • Air leakage from lungs
  • Pain
  • Longer operative times 
  • Longer time under anesthesia

References:

  • https://www.webmd.com/a-to-z-guides/what-is-a-thoracic-surgeon retrieved on March 06, 2022. 
  • https://medschool.ucla.edu/body.cfm?id=1158&action=detail&ref=898 retrieved on March 06, 2022. 
  • https://www.cancercenter.com/treatment-options/surgery/thoracic-surgery retrieved on March 06, 2022. 
  • https://www.mayoclinic.org/departments-centers/thoracic-surgery/sections/overview/ovc-20421043 retrieved on March 06, 2022. 
  • https://www.lung.org/lung-health-diseases/lung-procedures-and-tests/minimally-invasive-thoracic-surgery retrieved on March 06, 2022. 
  • https://ctsurgerypatients.org/what-is-a-cardiothoracic-surgeon retrieved on March 06, 2022. 
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