There are many different types of thoracic surgery, as it encompasses any surgery that is performed within the chest region, or thorax. This includes cardiac, lung and esophageal surgery. A thoracic surgeon is a specialized physician. Thoracic surgery may be elective or performed as an emergency procedure.
Thoracic surgeons perform a wide range of procedures, and becoming one takes a long time. After completing training as a general surgeon, a doctor must then specialize in thoracic surgery. Once they are thoracic surgeons, some choose to sub-specialize further.
Thoracic surgery may be divided into sub-specialties including cardiothoracic and general thoracic surgery. Cardiothoracic surgeons perform surgery on the heart. They may perform procedures on children, most commonly congenital disorders such as atrial or ventricular septal defects. In adults, cardiothoracic surgeons perform procedures such as bypasses, aneurysms and repair of leaking heart valves. All of these life-saving procedures require highly specialized knowledge.
Surgery of the lungs also falls under thoracic surgery. This includes procedures for lung cancer, emphysema and esophageal disorders such as hiatus hernias, gastroesophageal reflux and esophageal cancer. A thoracic surgeon differs from a pulmonologist in that a pulmonologist diagnoses and treats disorders of the lung while a thoracic surgeon performs open surgery.
Heart transplants are also part of thoracic surgery. First performed by South African surgeon Christiaan Barnard in 1967, this life-saving procedure involves the replacement of an unhealthy heart with the healthy heart from an organ donor. The procedure is complicated and may take five hours or more. After the heart transplant, the patient will need to take immunosuppessant medication to prevent rejection of the donor heart. Heart transplants may be performed on adults and children.
Esophageal disease, such as reflux, is common. If it is severe or does not respond to medication, surgery may be performed. The most commonly performed surgery for gastroesophageal reflux disease (GERD) is called a Nissen fundoplication.
During this procedure the thoracic surgeon makes a series of small incisions in the abdomen through which he works. This is known as keyhole surgery. He then wraps the stomach around the esophagus and staples it off. This tightens the esophageal sphincter and should stop acid from moving up the esophagus.
In the case of lung or esophageal cancer, diseased parts of the lung or esophagus may need to be removed. In severe cases, a lung transplant may be performed. Removal of part of the lung is termed a lobectomy, as the lungs are made up of numerous lobes.