Thoracic Surgery

 

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The Division of Thoracic Surgery at The GW Medical Faculty Associates is a comprehensive program specializing in minimally invasive thoracic surgery, including robotic and endoscopic treatments. Led by the Director of Thoracic Surgery, Keith Mortman, MD, our team continues to embrace advanced and innovative technologies applying research and cutting-edge surgeries to your care and treatment. Our surgeons are specialized with fellowships in thoracic surgery. Their pedigrees reflect rich academic backgrounds from some of the most prestigious US medical facilities.

We work meticulously to optimize your care. We offer highly-specialized, surgical treatment that addresses a wide range of health conditions that affect the lung, esophagus, chest wall, mediastinum, and tissues located between the sternum and vertebral column.

We pursue minimally-invasive surgical options – including robotic and endoscopic techniques – when they permit us to enhance your quality of care. We use robotics and/or tiny surgical instruments to get closer and clearer imaging of problematic areas and to surgically address thoracic problems. Robotic and/or endoscopic procedures often allow patients to recover faster and endure less post-surgical pain, compared to traditional open chest surgery. This, in turn, helps reduce your recovery time, the length of hospitalization and the cost of hospitalization.

Robotic Thoracic Surgery

Chest surgery using robotic technology is a minimally invasive procedure which stations your surgeon at a console with a high-definition display. Pedals and hand controls are used to maneuver mechanical arms equipped with tools including a 3-D camera. Successful robotic thoracic surgery can reduce the length of patients’ hospital stays and result in less post-surgery pain, because it can improve precision and limit surgical contact with surrounding tissues. Robotic thoracic surgery allows surgeons to remove masses in and around the chest using just a few small incisions between the patient’s ribs. However, no surgical procedure is totally risk-free. You and your doctor should always thoroughly discuss potential risks and benefits of any surgical approach.

Video-Assisted Thoracic Surgery (VATS)

Surgery for early stage lung cancer offers the chance for a cure. However, removing a lobe of a lung is considered major surgery. Minimally invasive surgical techniques like video-assisted thoracic surgery, or VATS, are helping surgeons excise malignancies in a less invasive way.

During a traditional lobectomy to remove a cancerous lobe of the lung, surgeons make a long incision following the ribs and then separate the ribs (and may remove a portion of a rib) to gain access to the chest cavity. In a VATS lobectomy, several small incisions are made, allowing surgeons to remove a tumor through a space between the ribs aided by special instruments and a camera.

Surgical Treatment for Cancer

Our team of thoracic surgeons is dedicated to the practice of general thoracic surgery, including lung cancer surgery. The side effects associated with lung cancer surgery depend on the specific type of surgery needed to remove the cancer — and how much of the lung needs to be removed. A strategic multifaceted pain management plan will be part of your individualized treatment regimen. It’s important to tell your doctor about any pain that you experience as a result of your surgical treatment.

Other Surgical Treatment Procedures

Bronchoscopy

A bronchoscopy is a diagnostic test used to view the inside of your lungs and breathing passages. Using a thin, lighted tube, called a bronchoscope, your doctor will view the airways. Your doctor may biopsy cells from both the breathing airways and the lungs. In addition, while performing a bronchoscopy, your doctor may make a decision to open an airway blocked by tumor or scarring, or place a stent.

Esophagoscopy

An esophagoscopy is a test designed to examine the esophagus, the muscular tube leading from the mouth into the stomach. Using a thin, lighted tube called an esophagoscope, your doctor will examine your esophagus and remove tissue to be examined later in the lab for potential signs of disease.

Mediastinoscopy

A mediastinoscopy provides a view of the inside of the chest. Your thoracic surgeon will make an incision at the top of the breastbone, and insert a thin, lighted tube to see inside the chest. Any abnormalities, including enlarged lymph nodes, will be removed for further examination in the lab.

Thoracotomy

Thoracotomy provides the physicians with an insightful view of the lung and surrounding tissue. A thoracotomy is usually performed as an inpatient procedure, so you will be required to stay in the hospital overnight. Your thoracic surgeon will explore the inside of the chest, and remove any abnormalities or lymph nodes for further examination in the lab.

Esophagectomy

Esophagectomy is the surgical removal of the esophagus. It may involve incisions in the neck, chest and/or abdomen. Some patients may be candidates for newer, minimally invasive approaches for esophagectomy. In most cases, your doctor will use your stomach to create a new esophagus and restore gastrointestinal continuity.

Chest Wall Resections

Sometimes treating a tumor requires a chest wall resection, or removal of a portion of the ribs and muscles of the chest wall. This can be done when the tumor comes from the chest wall or when there is a lung cancer that grows into the chest wall. This area may be reconstructed using artificial material, either gortex or mesh. The procedure may or may not require the assistance of a plastic surgeon for additional reconstruction.

Tracheal Resections

Tracheal resections and reconstruction can be done for benign or malignant conditions of the trachea. Typically, a portion of the trachea will be removed and the two sections will be put back together. This may involve an incision in the neck and the chest. These surgeries are done in cooperation with ear, nose & throat specialists.

Patients dealing with thoracic conditions could experience the following:

• Shortness of breath
• Lung infections
• Hemoptysis
• Barrett’s esophagus
• Hernias
• Achalasia
• Central airway obstruction
• Tumors
• Gastro esophageal reflux disease (GERD)
• Hyperhidrosis
• Other health conditions

Lung Cancer Screening

Lung cancer is the leading cause of cancer deaths in the United States for men and women, according to the Centers for Disease Control. Our Lung Cancer Screening program in partnership with George Washington University Hospital is designed to detect lung cancer in its earliest stages, when it is most treatable.

More information about Lung Cancer Screening

Thoracic Cancer Care Program

At The Medical Faculty Associates (MFA), the thoracic care program consists of specialists in the medical and surgical field of oncology to offer state-of-the-art treatment for patients with cancers of the lung, esophagus, chest wall, heart, and other disease conditions of the thorax. Our care goes beyond treatment, to offer smoking cessation, nutritional guidance, and social and personal support throughout treatment and beyond. Our cancer care program focuses on the individual patient, and our team emphasizes treatment strategies that attempt to maximize quality service, comfort, and compassion. With the team's guidance through the care process, the emphasis and importance of personalized medicine is maintained and a care plan is structured for the right patient in a timely fashion.

More information about the Thoracic Cancer Care Program

Incidental Lung Nodule Program

The Incidental Lung Nodule Program at GWU Hospital specializes in the evaluation, risk assessment, and management of incidentally detected lung nodules on imaging studies. Our goal is to provide prompt and evidence-based care for patients with pulmonary nodules and ensure that they are followed appropriately for better patient outcomes.

More Information About the Incidental Lung Nodule Program

Photo Caption

Picture left to right in first row:  Bitana Saintilma, RN (Thoracic nurse navigator), Patricia Rizk, RN (Thoracic nurse navigator), Keith Mortman, MD (Chief, Thoracic Surgery), Sora Ely, MD (Thoracic Surgeon), Sophia Ramsey, PA (Thoracic Surgery).

Second row left to right:  Sharad Goyal, MD (Director, Radiation Oncology), Khalil Diab, MD (Interventional Pulmonology), Jalil Ahari, MD (Pulmonary Medicine), Dan Baram, MD (Chief, Pulmonary Medicine), Faysal Haroun, MD (Medical Oncology), Ashley Manalel, PA (Medical Oncology)