Listed below are some of the more common thoracic surgery procedures performed by Swan Surgical.

da Vinci Surgical System
With the da Vinci Surgical System, surgeons operate through just a few small incisions. The da Vinci System features a magnified 3-D high-definition vision system and tiny wristed instruments that bend and rotate far greater than the human hand. As a result, da Vinci enables your surgeon to operate with enhanced vision, precision and control.

The da Vinci System represents the latest in surgical and robotics technologies. Your surgeon is 100 percent in control of the da Vinci System at all times. da Vinci technology translates your surgeon’s hand movements into smaller, precise movements of tiny instruments inside your body.

Bronchoscopy
Bronchoscopy is a technique of visualizing the inside of the airways for diagnostic and therapeutic purposes. This technique is used to view abnormalities of the airway; to obtain tissue specimens of the lung in a variety of disorders; or to evaluate a person who has bleeding in the lungs, possible lung cancer, a chronic cough, or a collapsed lung. An instrument called a bronchoscope is inserted into the airways, usually through the nose or mouth, or occasionally through a tracheostomy. This allows the practitioner to examine the patient’s airways for abnormalities such as foreign bodies, bleeding, tumors, or inflammation. Specimens may be taken from inside the lungs for further testing.

Mediastinoscopy
Mediastinoscopy is a surgical procedure that enables visualization of the contents of the mediastinum which is the central compartment of the thoracic cavity. It contains the heart, the great vessels of the heart, esophagus, trachea, phrenic nerve, cardiac nerve, thoracic duct, thymus, and lymph nodes of the central chest. A mediastinoscopy is usually performed for the purpose of obtaining a biopsy and is often used for staging of lymph nodes of lung cancer or for diagnosing other conditions affecting structures in the mediastinum such as sarcoidosis or lymphoma. Mediastinoscopy involves making an incision approximately 1 cm above the suprasternal notch of the sternum, or breast bone. Dissection is carried out down to the pretracheal space and down to the carina. A scope (mediastinoscope) is then advanced into the created tunnel which provides a view of the mediastinum. The scope may provide direct visualization or may be attached to a video monitor.

Lung Biopsy
Lung Biopsy is a procedure for obtaining a small sample of lung tissue for examination. The tissue is usually examined under a microscope, and may be sent to a microbiological laboratory for culture. Microscopic examination is performed by a pathologist. A lung biopsy is usually performed to determine the cause of abnormalities, such as nodules that appear on chest X-rays or a CT scan. It can confirm a diagnosis of cancer, especially if malignant cells are detected in the patient’s sputum or bronchial washing. In addition to evaluating lung tumors and their associated symptoms, lung biopsies may be used to diagnose lung infections, especially tuberculosis and pneumonia, drug reactions, and chronic diseases of the lungs such as sarcoidosis and pulmonary fibrosis. A lung biopsy is usually done when other tests cannot identify the cause of lung problems.

Hyperhidrosis
Hyperhidrosis is a disorder characterized by excessive sweating that occurs in up to 1% of the population. The excessive sweating can occur in the hands (palmar hyperhidrosis), in the armpits (axillary hyperhidrosis), or in the feet (plantar hyperhidrosis). This condition is sometimes brought on by stress, emotion, or exercise, but can also occur spontaneously. Sweating is controlled by the sympathetic nervous system and although there is ongoing research investigating this abnormality, it is not known what specific defect occurs that results in excessive sweating. Whether it is the over activity of the sympathetic nervous chain or the sweat glands themselves is uncertain. The surgical treatment of hyperhidrosis involves destroying or removing a specific portion of the main sympathetic nerve. The surgical therapy for hyperhidrosis entails removing or destroying the specific ganglion that causes sweating in the arm and the axillae. Ganglions are bundles of cells located at each vertebral level of the spine and are attached to one another to form the “sympathetic chain.” A sympathetic nerve branch comes off each ganglion and travels out to enervate blood vessels and sweat glands in the body. There are a variety of ways of dealing with the sympathetic ganglions including removing them, cauterizing them, cutting the branches, and clipping them. There are several different surgical techniques and all appear to be effective in a high percentage of cases. No specific technique has proved to be definitively superior to the others.

Thoracic Outlet Syndrome (TOS)
Thoracic Outlet Syndrome (TOS) is pain, numbness, tingling, and/or weakness in the arm and hand due to pressure against the nerves or blood vessels that supply the arm. It is due to tight muscles, ligaments, bands, or bony abnormalities in the thoracic outlet area of the body, which lies just behind the collar bone. Pressure on the nerves is the problem more than 90% of the time, but occasionally the artery or vein is involved. The most common symptoms include numbness and tingling in the fingers; pain in the neck, shoulder, and arm; headaches in the back of the head; weakness of the arm; and coldness and color changes in the hand. The symptoms are often worse at night or when using the arm for work or other activities. TOS is most often produced by hyperextension neck injuries such as whiplash injuries from auto accidents and repetitive stress in the workplace. Thoracic outlet surgery is designed to take pressure off the nerves to the arm and can be achieved by removing the muscles that surround the nerves (scalene muscles), by removing the first rib, or by doing both (removing muscles and first rib).

For information on procedures not listed here, please contact our office.