Thoracic Surgery

Treatments & Procedures:

Medications and therapy for COPD focus on improving breathing and managing symptoms through inhalers, medications, oxygen therapy, and pulmonary rehabilitation, which includes exercise training, breathing techniques, and lifestyle counseling. For severe cases, advanced treatments like bronchoscopic valve procedures, lung volume reduction surgery, or lung transplant may be considered to improve lung function and overall quality of life.

Treatments & Procedures:

The primary goals in treating empyema are to eliminate the infection and remove the pus from the pleural space. Treatment usually involves a combination of antibiotics to treat the underlying infection and surgical intervention to drain and remove the pus. The drainage might be done through insertion of a chest tube to drain the pus, or, in more severe cases, surgery to clean out the infected area (decortication). The choice of treatment depends on the severity of the empyema, the patient’s overall health, and how well the patient responds to initial treatments.

Surgical treatments include:

• Chest tube placement
• Intrapleural fibrinolytic therapy
• Video-assisted thoracoscopic or robotic surgery for decortication
• Open thoracotomy with decortication

Treatments/Procedures:

The management of lung cancer frequently requires aggressive multidisciplinary treatment. In complex cases, treatment options might include chemotherapy, immunotherapy, and targeted therapy, which are typically administered through infusion and/or radiation therapy.

Surgery is the most important treatment for patients with early-stage disease and may be the only intervention needed to control cancer or used in combination with other modalities, depending on the stage of the disease. The type of surgery used depends on the location and size of the tumor. Rigorous preoperative evaluation is required to ensure the surgery doesn’t negatively affect patients’ ability to breathe.

Surgical treatments include:

Lobectomy, segmentectomy, pneumonectomy, or wedge resection: Procedures that remove part of the lung, or all of it. These types of surgeries can be performed through a traditional open incision (thoracotomy) or with minimally invasive techniques, such as:

• Video-assisted thoracoscopic surgery (VATS)
• Robotic-assisted thoracic surgery

Endobronchial therapies: Treatments like laser therapy, liquid nitrogen therapy, or stent placement to help keep the airways open.

Radiation treatments include:

• Intensity-Modulated Radiation Therapy
• Image-Guided Radiation Therapy
• Stereotactic Body Radiation Therapy

Lung Cancer Screening:

Success in the treatment of lung cancer lies in early detection, when the treatment is most effective. Low-dose CT scans are used to screen high-risk individuals, enabling early diagnosis and treatment. Our team, in collaboration with our pulmonologists, runs one of the busiest Lung cancer screening programs in the state. Visit the Lung Cancer Screening Program page for more information.

Treatments & Procedures:

• Robotic-assisted and video-assisted thoracoscopic thymectomy
• Open sternotomy for tumor removal
• Extended resection for invasive thymomas

Treatments & Procedures:

Our lung surgery team offers advanced treatments and full support to help patients breathe better and live more comfortably. We use the latest care options and provide compassionate support to help patients manage their condition and improve their daily life. Surgical treatments include:

• Lung volume reduction surgery
• Bullectomy
• Bronchoscopic lung volume reduction (Endobronchial valve placement)

Treatments & Procedures:

• Imaging tests (CT scan, X-ray, PET scan) – Monitors nodule size and changes.
• Biopsy – Determines if the nodule is cancerous
• Robotic bronchoscopy – An advanced technology, allowing biopsy of small peripheral nodules to establish the diagnosis
• Surgical removal (lobectomy, wedge resection, or segmentectomy) – Removes cancerous or suspicious nodules
• Radiation or chemotherapy – If the nodule is cancerous and needs further treatment

Treatments & Procedures:

• Balloon dilation – Expands the narrowed airway.
• Airway stents
• Laser and cryotherapy
• Tracheal resection and reconstruction

Treatments & Procedures:

• Bronchoscopy with laser or cryotherapy
• Surgical tumor removal – Removes tumors from the airway or lungs
• Airway reconstruction – Repairs or rebuilds the airway after surgery

Treatments & Procedures:

• Airway stents – Keep weak airways open
• Surgery (tracheobronchoplasty) – Reconstructs and strengthens the airway walls

Treatments/Procedures:

Treatment depends on the cancer stage. Common options include chemotherapy, immunotherapy, surgery, and radiation therapy.

If the cancer has not spread, surgery (esophagectomy) is the primary treatment, often combined with chemotherapy and radiation. Minimally invasive techniques, such as robotic laparoscopic and thoracoscopic procedures, offer benefits to patients like reduced pain and faster recovery.

For advanced cases or patients unable to undergo surgery, chemotherapy and radiation are the main treatments. Palliative procedures help manage symptoms and improve quality of life.

Surgery

• Esophagectomy (robotic, minimally invasive or open)
• Endoscopic mucosal or submucosal resection

Non-Surgical Treatments

• Chemotherapy
• Radiation therapy
• Immunotherapy
• Targeted therapy

Palliative & Supportive Procedures

• Esophageal stent placement (to aid swallowing)
• Feeding tube placement (to boost nutrition)
• Palliative radiation or chemotherapy

Treatments and Procedures:

• Minimally invasive or robotic-assisted diverticulectomy
• Cricopharyngeal myotomy
• Endoscopic management (e.g., stapled diverticulectomy, D-POEM)

Treatments and Procedures:

Minimally invasive procedures are performed to improve food passage, relieve blockage, and improve quality of life. Advanced imaging and diagnostic procedures are required to diagnose this condition and guide treatment.

• Heller myotomy – surgery to cut tight muscles at the bottom of the esophagus
• Peroral endoscopic myotomy (POEM) – a less invasive procedure using a thin tube through the mouth
• Balloon dilation – stretches the tight area of the esophagus
• Botulinum toxin (Botox) injection – helps relax the muscles for short-term relief
• Esophagectomy – removal of the esophagus in rare, severe cases.

Treatments & Procedures:

• Lifestyle modification and medical therapy are the first treatments for patients with hiatal hernias. If those treatments fail or are no longer effective, surgery is the next option.
• Most surgical interventions are done minimally invasive, and include:
  • Minimally invasive, laparoscopic, or robotic hiatal hernia repair
  • Nissen, Toupet, or Dor fundoplication (to prevent reflux)
  • Magnetic sphincter augmentation (LINX device)
  • Endoscopic procedures (Transoral Incisionless Fundoplication)

Treatments & Procedures:

Pediatric Surgery treats chest wall deformities in children and teens, offering both surgical and non-surgical options. For adults, thoracic surgery focuses on outpatient care for related conditions.

• Nuss procedure (minimally invasive repair of pectus excavatum)
• Ravitch procedure (open repair of pectus excavatum or pectus carinatum)
• Customized chest wall reconstruction with prosthetics

Treatments & Procedures:

• Chest wall resection
• Reconstruction of the chest wall with prosthetic materials or flaps

Treatments & Procedures:

Non-Surgical Treatments:

• Pain management – Over-the-counter or prescription pain relievers (NSAIDs, acetaminophen)
• Breathing exercises – To prevent lung infections and improve healing
• Ice and rest – Reduces swelling and helps with pain
• Bracing or wrapping (only in some cases) – Provides support but is usually avoided to prevent breathing issues
• Physical therapy – Strengthens muscles and improves mobility

Rib Fracture Treatments:

• Pain control – Essential for proper breathing and healing
• Deep breathing exercises (incentive spirometry) – Prevents pneumonia and lung complications
• Activity modification – Avoiding heavy lifting or strenuous movement during healing
• Watchful waiting – Most rib fractures heal on their own within 6–8 weeks
• Surgical rib fixation – Uses titanium plates, screws, or wires to stabilize ribs that don’t heal on their own

Rib Nonunion Treatments & Procedures:

• Surgical rib fixation – Uses titanium plates, screws, or wires to stabilize ribs that don’t heal on their own
• Bone grafting – If needed, to help repair nonunion fractures

Treatments & Procedures:

Non-Surgical Treatments:

• Breathing exercises – Strengthens the diaphragm and improves lung function
• Positive airway pressure (CPAP or BiPAP) – Helps support breathing, especially during sleep
• Oxygen therapy – Provides extra oxygen if breathing is severely affected
• Physical therapy – Focuses on strengthening breathing muscles

Surgical & Interventional Treatments:

• Diaphragmatic plication – A surgical procedure that tightens a weak or paralyzed diaphragm to improve breathing
• Diaphragm pacing – Uses electrical stimulation to help the diaphragm contract
• Phrenic nerve repair – If the nerve controlling the diaphragm is damaged, surgery may help restore function

Treatments & Procedures:

• Pain management
• Physical therapy
• Manual manipulation to reposition the rib
• Surgical repair (for persistent cases)

Treatments & Procedures:

At UTMB, our multidisciplinary team, including experts from thoracic surgery and vascular surgery, provides timely, comprehensive care to improve arm function and reduce pain. Many surgeries are performed in the minimally invasive way, facilitating patient recovery and return to normal activities.

Surgical options might include:

• Comprehensive multidisciplinary evaluations with surgical specialists
• First rib resection
• Scalenectomy (removal of scalene muscles)
• Decompression of the brachial plexus
• Transaxillary approach for thoracic outlet decompression
• Supraclavicular approach for thoracic outlet decompression
• Venous or arterial reconstruction (for vascular thoracic outlet syndrome)
• Balloon angioplasty (for vascular compression)
• Neurolysis of compressed nerves
• Surgical correction of cervical rib anomalies (if present)

Treatments & Procedures:

• Sympathectomy
• Super selective sympathectomy (ramicotomy)
• These procedures are minimally invasive with video-assisted thoracoscopic surgery (VATS) and robotic surgery.

Treatments & Procedures:

• Medications: To improve communication between nerves and muscles or control the immune system (e.g., anticholinesterase drugs, steroids, or immunosuppressants)
• Plasmapheresis: A treatment that removes harmful antibodies from the blood
• IVIG (intravenous immunoglobulin) – Helps block the immune attack
• Thymectomy: Surgery to remove the thymus gland, often done by a thoracic surgeon
• Lifestyle changes: Resting often, avoiding stress or extreme heat, and working with a care team to manage symptoms