THORACIC & MINIMALLY INVASIVE THORACIC SURGERY

Making recovery faster for patients

Lung Cancer (primary / secondary) (read more)

  • Thoracotomy, Sternotomy, Clamshell approach, Minimally Invasive approach / Video-assisted thoracoscopic surgery
  • Lobectomy
  • Bilobectomy
  • Wedge resection / metastesectomy
  • Segmentectomy
  • Pneumonectomy
  • Extrapleural Pneumonectomy
  • (Mesothelioma Stage 4A thymoma)
  • Robotic assisted resection

Mediastinal Tumor Surgery

  • Thymectomy, neurogenic tumor, leiomyoma
  • Conventional sternotomy
  • Partial stectomy (6cm)
  • VATS resection
  • Clamshell
  • VATS biopsy
  • Chamberlain procedure

Mediastinal Lymph Node Surgery

  • VATS biopsy
  • VATS clearance

Lung Biopsy (VATS)

  • Nodule resection
    • Diagnostic
    • Interstitial Lung Disease
  • Infection
  • Malignancy

Pleural Surgery (VATS)

  • Pleurodesis
    • Pneumothorax
    • Pleural effusion
    • Chylothorax
  • Plueral biopsy
  • PleurX catheter insertion

Infection

  • Decortication
  • Lung abcess damage
  • Lung resection

Chest Wall Surgery

  • Resection & reconstruction
    • Infection
    • Tumor
  • Pectus excavatum repair
    • Nuss procedure
    • Ravitch procedure

Mediastinoscopy

  • Cancer Staging
  • Diagnosis
    • Tuberculosis
    • Sarcoidosis
    • Lymphoma
    • Other Malignancies

Sympathectomy (read more)

  • Sweaty Palm
  • Sweaty Arm Pit

Thoracic Duct Ligation for intractable chylothorax

First Rib Resection

Esophageal Surgery

  • Esophagectomy
    • Transhiatal
    • Thoracobdominal approach
    • 3 Stage approach
    • VATS
  • Esophageal perforation repair
  • Heller Myotomy for Achalasia
  • Collis Nissen fundoplication

Chest Trauma

  • Emergent room thoracotomy
  • VATS evacuation of hemothorax

Lung Failure Surgery

  • Lung volume reduction surgery (LVRS)
  • Veno-venous ECMO therapy

Diaphragm

  • Repair
  • Plication for diaphragmatic paralysis

The traditionally approach for a surgeon to gain access to the chest is performed involving a 10-15 cm incision (cut) on the chest. This is still the gold standard in certain thoracic conditions including lung cancer surgery but it is invasive as it involves a large incision and rib spreading. This is the commonest approach but the disadvantages are that it also translate into more chest trauma, pain and slower return to baseline activities.

Video Assisted Thoracoscopic Surgery (VATS) is an advanced form of alternative approach which allows trained thoracic surgeons to achieve the same goal as the thoracotomy. Through one to three small incisions (measuring 5-12 mm each), it enables the surgeon to view the whole chest  cavity with a small video camera. The images are then projected onto a high resolution computer monitor. In our centre, it is routinely used to perform diagnostic procedures such as lung, pleura, mediastinal lymph nodes and tumors biopsy. With this expertise, this state-of-art technique further allows our surgeons to safely carry out treatment of numerous thoracic conditions as follows:

Pleurodesis
Pneumothorax (air in chest cavity)
Pleural effusion (fluid in chest cavity)
Chylothorax (lymphatic fluid in chest cavity)

Decortication of empyema

Lung volume surgery for severe emphysematous lungs

Resection of mediastinal tumors
Thymoma
Neurogenic tumor
Bronchogenic cyst
Leiomyoma

Lung cancer Surgery
Wedge resection (usually for secondary cancer spread from other organs)
Segmentectomy
Lobectomy (Gold standard)

Esophagectomy for esophageal cancer

Sympathectomy for sweaty palms and/or sweaty arm pits

Drainage of hemothorax (blood in chest cavity)

With small incisions and non rib spreading techniques, VATS offers numerous benefits, including less pain after operation, early mobilization, better immune response and earlier return to normal activities.

As technology continues to evolve and better understanding of minimally invasive techniques by our surgeons, we have employed Da Vinci robot to assist lobectomy in lung cancer patients recently. Robotic surgery consists of the main surgeon remotely controlling the robotic instruments via a console a few feet away from the patient. A bedside surgeon, by watching the video monitor, will assist the main surgeon in handling the robotic instruments and attend to any situations that may arise.

With the modern video technology, the surgeon is now able to obtain true 3 dimensional, high resolution and highly magnified views of the surgical field. Of the many advantages, the robot also offer superior articulation of the instruments in the chest while eliminating the tremor of human hands. As a result, the surgeons can now perform surgery with higher precision in a safer environment.