Thoracic surgery refers to operations on organs in the chest, including the heart, lungs, and esophagus. Examples of thoracic surgery include coronary artery bypass surgery, heart transplant, lung transplant and removal of parts of the lung affected by cancer. Specialized thoracic surgeons treat lung and esophageal cancer, while specialized cardiac surgeons treat the heart.
Thoracic surgery, also known as chest surgery, may be used to diagnose or repair lungs affected by cancer, trauma or pulmonary disease. For lung cancer, your surgeon may remove nodules, tumors and lymph nodes to diagnose, stage and treat the disease.
Thoracic surgery procedures may be performed with either minimally invasive techniques or an open surgical procedure called a thoracotomy.
Team MediGence (Dr. Guneet Bhatia, Co-Founder & Director – Patient Care, MediGence) interviewed Dr. Narendra Aggarwal, a renowned Thoracic (Chest) Surgeon in Fortis Memorial Research Institute (FMRI), India. Below is the transcription of the same.
Team MediGence: Hi everyone, I am Dr. Guneet, I am Co-Founder & Director of Patient Care at MediGence. Today we have with us, Dr. Narendra Aggarwal. He is a thoracic surgeon who is working for Fortis Hospital in Gurgaon, India. Thank you for being with us. So to start with can you please tell us about a few procedures that you do on a day to day basis.
Dr. Narendra Aggarwal: As a thoracic surgeon, we deal with chest disease. Chest diseases which are non-treatable medically, and diseases like an endoscopic surgical resection. It involves diseases in the lung such as lung cancer, aspergilloma lung infections, tuberculosis, and then we have bronchitis and emphysema. So we have in between the center of the chest also called medial sternum area, the mediastinum tumors also called thymoma lymphoma which is another of such diseases. Then we also have chest wall deformities and we have a correction of chest wall deformities. At the same time, we deal with food pipe and windpipe diseases.
Team MediGence: Great. So can you tell me about thoracotomy? What kind of a procedure is it, and what body part is utilized?
Dr. Narendra Aggarwal: Thoracotomy is a procedure where we open the chest, we tract the ribs, sometimes there is blood on the ribs, and we open the muscles to get inside the area of operating. So that is what we refer to as thoracotomy.
Team MediGence: Nowadays we are also hearing a lot of advancements in minimally invasive surgeries. What kind of surgeries are those? Are those safe and successful?
Dr. Narendra Aggarwal: Minimally invasive surgeries are a new technique, which we opt for such as laparoscopy. We call this video-assisted thoracic surgery or minimally invasive thoracic surgery. They have different names, it is basically the technique. The surgical method remains the same, but it involves using a camera, and specialized instruments with which we operate. The main advantage of this is we have minimum scars. So the healing time, and recovery time is less. So yes, technically it is a good method.
Team MediGence: So you would call this method more advantageous?
Dr. Narendra Aggarwal: Yes, this would definitely be an advantage. And there are more advantages. While operating on a patient via thoracotomy (the recovery) is 7-8 days, while the recovery via minimally invasive surgery is 4-5 days. The patient has fewer pain scores. So when the pain score is less, the patient recovers faster and can be back to home/back to work earlier as well.
Team MediGence: And what about the post-op care and recovery like, once the surgery is finished?
Dr. Narendra Aggarwal: Post-op care remains the same. Pain score is also less, and the use of anesthesia is also less, hence the recovery time is faster. And all the other factors are also at a minimum.
Team MediGence: So we have a lot of patients who travel from abroad and plan to travel to our country, so what are the precautions they need to keep in mind before traveling?
Dr. Narendra Aggarwal: See any patient who plans to be in India for thoracic work, we need to evaluate the patient with the previous reports, scans, films everything and whatever the last physician or the doctor who has seen should have a correct summary of notes where we can actually evaluate what was the disease or what was the plan. So this the main objective of the patient to come down we know why the patient is here and we know why we are evaluating the patient.
Team MediGence: As far as the investigations are concerned what will you recommend the patient should get the things done before the patient flies, that would be easier for you and save our time
Dr. Narender Aggarwal: See if we have to say what investigations, then we always in touch with the patient who is planning to fly, we can discuss those patient time to time what they want and when we have the brief history of the patient then we plan what we exactly want from the patient. So the first primary thing is we need to have when first chest x-ray was done, what was the problem, what was the disease, what was the history of the patient. So we need to have a chest x-ray as a primary investigation accordingly we decide what we want further may be good modality is chest CT, then contrast CT scan and then requirement might be a bronchoscopy so depends upon the patient to patient and disease to disease so we cannot define the list of investigations. We should always have the basic investigations done.
Team MediGence: What is the kind of time range that you would suggest that a patient would need in the country or in the hospital.
Dr. Narender Aggarwal: Every disease and the patient are different we cannot put a defined timeline that this is the amount of time you need to be here in the hospital or country. So minimum time we calculate is by the time of admission and the time of discharge and what we know is generally if we are operating through minimally invasive route it is comparatively less than the open surgeries. So all depends upon the modality we choose and how is the clinical condition of the patient when he is in the hospital so that also decides the amount of stay in the hospital. On average we can always say a minimum of 5 to 7 days of hospital stay is always there and keeping almost 2 weeks outside the hospital so we can have a good follow-up and we can decide the patient is fit enough to go back.
Team MediGence: Thank you so much, sir, for your time this video will really help patients and their relatives who are planning to travel abroad for the treatment.
Dr. Narender Aggarwal: Thank you!