Weaning and Extubation

Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway or to serve as a conduit through which to administer certain drugs.

It is frequently performed in critically injured, ill, or anesthetized patients to facilitate ventilation of the lungs, including mechanical ventilation, and to prevent the possibility of asphyxiation or airway obstruction. The opposite of intubation is extubation. The process of removing a tube from a hollow organ or passageway, often from the airway.

Rib Fracture Fixation

Rib Fracture Fixation (Flail chest): Flail chest is an injury that occurs typically following a blunt trauma to the chest. 

When three or more ribs in a row have multiple fractures within each rib, it can cause a part of your chest wall to become separated and out of sync from the rest of your chest wall. It’s considered an emergency, as there could be a severe associated lung injury, and it’s imperative that you’re treated immediately.

It’s rare for this to occur as a consequence of chest trauma, but when it does happen, flail chest can severely affect your ability to breathe and cause you considerable health concerns.

Tracheal Stenosis

Tracheal stenosis, including subglottic stenosis, is a narrowing of the trachea that causes breathing problems.

Tracheal stenosis, including subglottic stenosis, is a narrowing of the trachea that causes breathing problems. It can develop when scar tissue forms in a person’s trachea due to prolonged intubation — when a breathing tube is inserted into the trachea to help maintain breathing during a medical procedure — or from a tracheostomy, which is a surgery to create an opening in the neck to access the trachea.

Chest Tube

A chest tube can help drain air, blood, or fluid from the space surrounding your lungs, called the pleural space.

Chest tube insertion is also referred to as chest tube thoracostomy. It’s typically an emergency procedure. It may also be done after surgery on organs or tissues in your chest cavity.

During chest tube insertion, a hollow plastic tube is inserted between your ribs into the pleural space. The tube may be connected to a machine to help with the drainage. The tube will stay in place until the fluid, blood, or air is drained from your chest.

VATS Wedge resection

Wedge resection is a surgical procedure to remove a triangle-shaped slice of tissue.

It may be used to remove a tumor or some other type of tissue that requires removal and typically includes a small amount of normal tissue around it. It is easy to repair, does not greatly distort the shape of the underlying organ and leaves just a single stitch line as a residual.

VATS Bullous Emphysema

Emphysema, also called pulmonary emphysema, condition characterized by widespread destruction of the gas-exchanging tissues of the lungs, resulting in abnormally large air spaces.

Lungs affected by emphysema show loss of alveolar walls and destruction of alveolar capillaries. As a result, the surface available for the exchange of oxygen and carbon dioxide between inhaled air and blood traversing the lungs is reduced. In addition, loss of elastic tissue from the walls of the destroyed alveoli causes the lungs to expand within the chest cage. The expanded lungs compress the small bronchi and thus increase resistance to airflow. This is especially evident during expiration, when contraction of the muscles of the chest wall and abdomen increase intrathoracic pressure and further reduce the passage of air through the small bronchi.

Pectus excavatum Nuss Procedure

Pectus excavatum (funnel chest) is a congenital defect that causes the chest wall to appear sunken. It often results in lack of confidence and shortness of breath.

In most people pectus excavatum (funnel chest) presents before the age of one, but in some cases it does not become apparent until the onset of puberty. It is seen four times more frequently in boys than in girls. Patients who have mild symptoms may be helped by physical therapy. If you have moderate to severe pectus excavatum with physical symptoms and serious cosmetic effects, we often recommend surgery. The vast majority of the patients with pectus excavatum are candidates for the Nuss procedure. The operation takes 30 – 60 minutes. During the operation two to three (maybe more) 5 cm incisions is made. A camera is inserted through one of the wholes allowing the surgeon to monitor the procedure and avoid injury to the heart during insertion. Through the latter the specialist will insert 1-2 or perhaps 3 steel bars under the sternum so that it is pressed out into a normal position. Local anaesthetic will be applied to the wounds when the operation has been completed. The wounds will be closed using absorbable sutures, and plasters will be applied to them.

VIDEO Assisted Mediastinoscopy

A mediastinoscopy with biopsy is a minor surgical procedure that gathers samples of lymph nodes

Lymph nodes are clusters of cells that play a key role in fighting off viruses and bacteria in your body. A surgeon takes the tissue sample from your chest. A surgeon inserts a small instrument with a light—called a mediastinoscope—through an incision in your throat. They run it under your sternumN (breastplate) and move it into the area between your lungs. You’ll be under general anesthetic during the biopsy.The test looks for any abnormalities and takes one or more small tissue samples, called biopsies. Lab technicians examine and assess the biopsies in a lab. This test commonly checks for cancer.

VATS Lobectomy

What is a lobectomy?

A lobectomy is the surgical removal of a lobe of an organ. It most often refers to the removal of a section of the lung, but it can also refer the liver, brain, thyroid gland, or other organs.Every organ is made up of many sections that perform different, specific tasks. In the case of the lungs, the sections are called lobes. The right lung has three lobes, which are the upper, middle, and lower lobes. The left lung has two lobes, the upper and lower lobes.In most cases, surgeons perform a lobectomy to remove a cancerous portion of an organ and to prevent the cancer from spreading. This may not entirely get rid of the disease, but it can eliminate the primary source of it. A lobectomy is the most common way to treat lung cancer.Surgeons may also perform lobectomies to treat:Fungal infections; Benign tumors; Emphysema; Lung abscesses; Tuberculosis

Thoracic Empyema

Pleural-thoracic empyema or pyothorax refers to an infected purulent and often loculated pleural effusion, and is a cause of a large unilateral pleural collection. It is a potentially life-threatening condition requiring prompt diagnosis and treatment.

VATS Diaphragm Plication

Plication of the diaphragm is performed for paralysis or eventration (abnormal elevation/shape) of the diaphragm which can result in breathing difficulties. Diaphragm paralysis is typically due to damage to the phrenic nerve; eventration is most commonly congenital. Surgical plication to stabilize the diaphragm is needed to prevent the lungs from ballooning outward during expiration (breathing out), the opposite of normal function.

Palmar Hyperhidrosis ETS

Palmar hyperhidrosis, or excessive hand sweating, is a common condition affecting 1-3% of the population. It usually starts in childhood or adolescence. Sweaty hands can significantly affect a person socially and emotionally.

Endoscopic thoracic sympathectomy (ETS) is a surgical treatment option for various forms of hyperhidrosis. In which a portion of the sympathetic nerve trunk in the thoracic region is destroyed.It is conducted by a vascular or neurosurgeon under general anaesthesia. It has a very high success rate for treating palmar hyperhidrosis but carries a significant risk of compensatory or “rebound” sweating. Compensatory sweating occurs in areas such as the back or lower limbs weeks to months after ETS surgery. Compensatory hyperhidrosis can be difficult to treat and usually persists for life.An in-depth discussion with your vascular surgeon or neurologist is needed prior to considering ETS surgery.