Patients come to our office for findings of lung nodules seen on an X ray or CT scan. These nodules are not always cancer and are sometimes followed with repeat imaging and CT scans. When the nodules change or appear worrisome for cancer there are several options. Patients can undergo a needle biopsy of the nodule (an outpatient procedure) for diagnosis. If the nodule is found to be cancerous, they can be treated with surgery, or a combination of chemotherapy and/or radiation treatment. Our physicians guide patients through this process and often times utilize a multi-disciplinary hospital conference where physicians in thoracic surgery, radiology, oncology, radiation therapy, and pulmonary medicine come together to decide on best treatment options for that patient.
The Da Vinci Xi robotic surgical platform is a state-of-the-art system to perform minimally invasive surgery (MIS). This results in a shorter time in the hospital, less blood loss, fewer complications, and a quicker return to your life. Powered by robotic technology that allows the surgeons hand movements to be translated into smaller, precise movements inside the patient's body. This system enables a surgeon to perform operations through a few small incisions in the chest and also gives the surgeon a 3D high-definition view inside the body. The surgeon is 100% in control of the robotic system at all times. Lung resections are performed with the robot. Usually, the lobe of the lung where the nodule, mass, or cancer is located is removed, along with all the lymph nodes in the area. Occasionally, the procedure cannot be completed via small incisions, and this requires the procedure to be converted to a thoracotomy (open procedure). The robotic platform is our main tool to perform surgery. Most robotic surgery patients can expect an overnight stay in the hospital and discharge the next day.
Video assisted thoracic surgery (VATS) was the first minimally invasive surgery platform introduced in the 1990s. This platform allows the surgeon to see inside the chest with a handheld camera and table side video screens. Instruments are introduced into the chest cavity through a small 4-to-6-inch incision and remove a portion of the lung. Our group utilizes VATS for wedge resections, clean out of infections, and pleural biopsies.
A thoracotomy involves a larger incision in the skin, division of the underlying muscles, and spreading of the ribs. In our practice this incision is used when the surgeon is unable to use the robotic system or VATS due to the size, location, or involvement of other structures by the mass. This approach may lengthen length of stay and overall healing time.