Barts and The London Heart and Chest Centre | Your journey of care | Thoracic or chest surgery

Barts and The London Heart and Chest Centre

Thoracic or chest surgery

At Barts and The London Thoracic Surgery Centre, we provide a full range of treatments for patients who require surgery for benign or malignant diseases of the lung, pleura (lining of the lungs) and chest wall.

The thoracic area is anywhere between the base of the neck and the diaphragm.

Thoracic surgery is carried out to diagnose, treat with the aim of cure or palliate patient’s symptoms. Access to the chest cavity is obtained by either an incision in the side of the chest (thoracotomy) or by inserting a thoracoscope (key hole surgery).

Video-assisted thoracic surgery

Video-assisted surgery is often used to diagnose or palliate diseases of the lung or its lining. A thorascope (fibre-optic camera) is passed into the chest via a small incision to allow the surgeon to guide their instruments.

Types of thoracic surgery

Surgery to remove cancers/tumours

Patients with suspected cancers are managed by multi-disciplinary teams comprising respiratory physicians, radiologists, thoracic surgeons, oncologists, pathologists and palliative care specialists. We work closely with our colleagues in the cancer centre to diagnose and treat patients with lung cancer, mesoithelioma (cancer in the lining of the lung), lymphoma and thymoma (tumour of the thymus gland).

All patients are treated as individuals from diagnosis and throughout their care. Symptom control and palliative care are also offered to patients.

For patients with mesothelioma, we offer the full range of diagnostic and palliative surgery usually performed by video assisted thoracic surgery (VATS) - also known as keyhole surgery. We also offer surgery with aim of cure including pleuropneumonectomy which is performed via a thoracotomy.

For more details about our cancer services, please click here.

Surgery is the best treatment for lung cancer, if surgery can remove the entire tumour and the patient is well enough to undergo the operation. Lobectomy (removing part of the lung) or pneuonectomy (removing the entire lung) is usually performed by thoracotomy. A thoracotomy is an incision which looks at the lungs by carrying out a cut along the side of the chest.

Further information

Click here to visit the CancerBackup website
Click here to visit the Cancer Research UK website

Surgery to diagnose and treat benign chest disease

We use a range of surgical techniques to diagnose lung diseases including tuberculosis, pneumothorax (air within the chest) and empyema (pus within the chest).

A bronchoscopy is procedure which helps us to diagnose conditions of the airways. Common reasons for having a bronchoscopy include if a patient has been coughing up blood, has a persistent cough that has not responded to the usual medications, and has abnormal chest x-ray findings.

The procedure uses a bronchoscope – a flexible tube with a bright light at the end – which is inserted through the nose or mouth and into the windpipe.

Video assisted thoracic surgery (VATS), also known as keyhole surgery, is used to treat pneumothorax where air has collected within the chest and is collapsing the lung. The area where air is leaking out of the lung is sealed and the lung is stuck to the inside of the chest wall to prevent further collapse.

Pus within the chest that causes the lung to collapse is usually removed by a thoracotomy to allow the lung to fully re-expand.

Surgical correction of chest deformities

There are two types of pectus abnormalities (irregular chest shapes). Patients may wish to have their abnormality corrected if it causes respiratory problems, chest pain, or psychological distress. Surgery is the main form of treatment.

Pectus excavatum is commonly known as funnel chest where the breastbone (sternum) is depressed in a concave shape

Pectus carinatum is known as pigeon chest where the breastbone sticks out in a convex shape.

There are two operations to correct these defects. The Nuss procedure is a keyhole technique to place one or two curved steel bars behind the breastbone forcing it forward. The Ravitch procedure involves removing the costal cartilages on either side of the breastbone and then placing a bar behind it to hold it in the correct place. After approximately two years the bar is removed.

Our specialist cardiothoracic surgeons operate on around 20 patients each year with pectus deformities.

Barts and The London is a major trauma centre receiving patients via the Helicopter Emergency Service and cardiothoracic surgery provides surgical treatment for patients who have major chest injuries.