Thoracic surgery

We offer several surgical procedures of the airway, including tracheal resections and the treatment of trachea-oesophageal fistula. There is a comprehensive endobronchial airway service and we are able to offer cryotherapy, endobronchial resection, flexible and rigid bronchoscopy, and stenting.

This is an investigation of the airways, using a bronchoscope (a small flexible telescope). The bronchoscope is passed through your mouth and into your windpipe, so that the surgeon can examine your airways, and take a small sample of tissue (biopsy), to find out what is causing your symptoms. A bronchoscopy is usually carried out under general anaesthetic.

Chest wall surgery includes cancer resections for lung cancer, primary chest wall tumours and secondary tumours to the chest wall. We offer chest wall stabilisation and reconstruction after surgery.

Including sleeve resections, other lung-sparing surgery, chest wall resections and resections involving the heart or great vessels.

We offer an 'easy-access pleural service', and aim to achieve a diagnosis and to alleviate the problem in as few as steps as possible.

We have expertise in the management of pneumothorax, pleural effusions, empyema and pleural tumors such as mesothelioma.

Patients are referred to the CTC with early lung cancer, locally advanced lung cancer (T3/T4) or when there is limited spread (N2) and in highly selected patients metastatic disease (M1).

All such cases are discussed in a multi-disciplinary group, and if appropriate we may be able to offer surgery supported by additional treatments such as chemotherapy and radiotherapy.

We receive requests for second opinions and also consider patients for surgery when other options may have been unsuccessful.

This established treatment can help some people by removing poorly functioning parts of the lung which allows the rest of the lung to work better and also reduces the effort needed to breathe.

This is an examination of the lymph nodes, using a short endoscope (a small flexible telescope). The endoscope is passed through a small incision made at the base of the neck under the chin. A mediastinoscopy is carried out under general anaesthetic.

We offer a range of operations for tumors and in the mediastinum.

Some people with mestastases to the chest may benefit from resection of these tumors. Each case is very carefully assessed to allow the best decision to be made for the patient.

Where possible and appropriate, keyhole surgery is used. This is performed with the help of small operating telescopes which often give an excellent view and is known as 'video-assisted' or 'VAT' surgery.

During an open lung biopsy, a small incision is made in the chest so that samples of tissue (biopsies) can be taken, to find out what is causing your symptoms. This procedure is carried out under a general anaesthetic. A chest drain may need to be inserted following the procedure, to drain fluid or air.

We offer pectus operations and sometimes operate with plastic surgery colleagues to produce the best results.

Each person is assessed on their own merits. Some patients may have been advised that they are inoperable due to poor lung function.

Our approach is try to improve their breathing and other illnesses to see if they can tolerate an operation. If surgery is performed we may advise a lung-sparing approach, and such patients benefit from our experienced specialist intensive and nursing care.

Sarcomas are a form of tumour.

We work with oncologists who also have a special interest in this area, with the aim of getting the best results.

This is an investigation of the inside of the chest area, using an endoscope (a small flexible telescope).

The endoscope is inserted through the chest wall, so that the surgeon can examine the area, and take a small sample of tissue (biopsy). A thoracoscopy is carried out under general anaesthetic. A chest drain may need to be inserted following this procedure, to drain fluid or air.

A thoracotomy is an operation which involves making an incision into the chest wall (thorax). This allows the surgeon to operate on your lung. Some of the procedures the surgeon may carry out include:

• Lobectomy - the removal of a part (a lobe) of the lung.
• Pneumonectomy - the removal of an entire lung.
• Pleurectomy – the removal of the lining of the chest wall (called the pleura), to allow the lung to 'stick' to the chest wall. This procedure is carried out for persistent collapse of the lung (pneumothorax).
• Decortication - the removal of any pus or debris from the lining of the lung. This procedure is carried out under general anaesthetic.

The role of clinical perfusion is providing artificial heart and lung support.

The ability to remove blood before it enters the heart and lungs and return it to the body after the heart is key to facilitating nearly all cardiac surgery. If blood is not passing through the heart and lungs the function that these organs provide needs to be replaced. This is done artificially. Blood is filtered, pumped, oxygen is added, carbon dioxide is removed and the temperature is controlled.

Blood is important to fighting infection and promoting healing. The CTC uses state-of-the-art perfusion technology to make the artificial heart and lung support as similar to normal bodily function as possible. We aim to provide artificial heart and lung support during surgery without the blood or body knowing it has happened.

None of the patient’s blood is lost, which increases the chances of leaving hospital earlier, and reduces the risk of receiving donor blood.