The type of thoracic surgery you have depends on the type and stage of your cancer, your lung function and other criteria. Your thoracic surgeon will help you decide the best treatment plan for you.

Many types of thoracic surgeries can be used to treat lung cancer. These procedures are done to remove cancerous cells or to relieve symptoms of breathing problems.

Transbronchial needle aspiration (TBNA), a method for obtaining tissue or fluid samples from the lungs and surrounding lymph nodes without traditional surgery, is made possible by EBUS. The samples can diagnose and stage lung cancer, find infections, and determine cancers like lymphoma or inflammatory diseases like sarcoidosis that affect the lungs. Although an EBUS is frequently used to diagnose lung cancer, it can also identify other lung conditions, such as lung inflammation or infection. The surgeon specializing in this procedure, such as Armen Parajian, could perform EBUS. The information obtained during the EBUS procedure might be helpful to the patient’s medical team to determine the best course of treatment if lung cancer is found.

Video-Assisted Thoracic Surgery (VATS)

Video-Assisted Thoracoscopic Surgery (VATS) is a minimally invasive surgical technique that can help with cancers of the lungs and chest. During this procedure, surgeons make one or more small cuts between your ribs and pass a thoracoscope and other unique instruments through the holes to perform the surgery.

Compared to traditional thoracotomies, VATS uses more minor cuts and can be performed under local or general anesthesia. It also has fewer complications and requires less recovery time.

Doctors may occasionally advise a uniportal video-assisted thoracic surgery. This type of procedure allows for access to the chest through one incision, which can reduce complications and improve recovery times.

Robotic Thoracic Surgery

Robotic thoracic surgery is minimally invasive for lung cancer and other thoracic procedures. It can reduce pain and hospital stay, as well as make a recovery easier.

The procedure involves making minor cuts (incisions) in the chest. Next, a surgeon sits at a console and uses a camera to see inside your lungs. The console transmits the camera’s 360-degree view to the surgeon.

This view guides the surgeon’s wrist movements, which control tiny surgical instruments. The surgeon removes diseased tissue through one of the incisions.

During the procedure, a chest tube is inserted through one of the small incisions to drain fluid or air from your chest cavity and help your lungs re-inflate.

UCSF has pioneered robotic thoracic surgery and has a team of surgeons and staff experienced in this technology. They work with anesthesia, nurses, and other health care providers to provide state-of-the-art innovative perioperative care for patients before and after robotic surgery.

Open Thoracic Surgery

Thoracic surgery is a type of major surgery used to treat diseases and problems of the heart, lungs, and esophagus. It is a complex procedure and requires a highly trained and experienced surgeon.

Open thoracic surgery is performed by incision (cut) into the chest. 

In this type of thoracic surgery, the surgeon may need to remove a rib to access the lung. This procedure is sometimes required for lobectomy or pneumonectomy to remove a cancerous part of the lung.

This surgery is usually performed under general anesthesia. It involves making a large incision and spreading the ribs to reach the lung and other organs. This major surgical operation can cause complications if not performed correctly.

Tracheal Resection or Stent Insertion

Tracheal resection or stenting is an established procedure for several conditions. It is used to treat tracheal stenoses (narrowing of the trachea), stridor and, in some cases, respiratory failure.

There are two main types of tracheal stents: silicone and metallic. Silicone stents treat benign conditions, while metallic stents are more commonly used for malignant diseases.

Although both stents have advantages and disadvantages, each type should be chosen carefully to optimize treatment and results. Stents are typically used for 2 main reasons: (1) to minimize extrinsic compression from tumors or lymphadenopathy, and (2) to maintain patency after bronchoscopic tumor removal due to intrinsic obstruction, heal airway fistulas or anastomotic dehiscence post-lung transplantation.

In general, stent insertion is a relatively simple surgical procedure. It requires a flexible bronchoscope with fluoroscopic guidance through an endotracheal tube and stent placement under local or general anesthesia.