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Frequently asked questions

What are the treatment options of flail 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.

What is the best age for surgical treatment of Pectus Excavatum?

The ideal age for intervention in patients with symptomatic Pectus Excavatum is from 8 years old to pre-pubescence, 12-14 years old (adolescents prior to growth spurt). It is advisable to have the procedure before the age of 20 so that Pectus Excavatum consequential pathologies (e.g. scoliosis, rib deformities, etc.) neither appear nor worsen.

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.

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.

What is pneumothorax?

A pneumothorax is a collapsed lung. A pneumothorax occurs when air leaks into the space between your lung and chest wall. This air pushes on the outside of your lung and makes it collapse. In most cases, only a portion of the lung collapses. A pneumothorax can be caused by a blunt or penetrating chest injury, certain medical procedures, or damage from underlying lung disease. Or it may occur for no obvious reason. Symptoms usually include sudden chest pain and shortness of breath. On some occasions, a collapsed lung can be a life-threatening event. Treatment for a pneumothorax usually involves inserting a flexible tube or needle between the ribs to remove the excess air. However, a small pneumothorax may heal on its own.

What is a bullectomy?

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.

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.

Why do I need a mediastinoscopy with biopsy?

Your doctor might order a mediastinoscopy with biopsy for several reasons. They may want to:
• See if a cancer in the lung has spread to the lymph nodes

• Check for other lymphatic cancers, including Hodgkin’s disease or lymphoma

• Identify infections, such as tuberculosis

Doctors often use mediastinoscopy to understand how far lung or other cancers have advanced. This is also known as staging the cancer, or determining what stage your cancer has reached. This information can help you and your doctor select the most appropriate course of treatment.

What is VATS procedure?

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgical technique used to diagnose and treat problems in your chest.

During a video-assisted thoracoscopic surgery procedure, a tiny camera (thoracoscope) and surgical instruments are inserted into your chest through small incisions in your chest wall. The thoracoscope transmits images of the inside of your chest onto a video monitor, guiding the surgeon in performing the procedure.

What are the benefits of a lobectomy?

Having a lobectomy can stop or slow the spread of cancer, infections, and diseases. Performing this surgery may also allow your doctor to remove a portion of an organ that affects the function of other organs. For example, a benign tumor may not be cancerous but may press against blood vessels, preventing adequate blood flow to other parts of the body. By removing the lobe with the tumor, your surgeon can effectively solve the problem.

How is it palmer hyperhidrosis treated?

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.

What are the indications for chest drain (chest tube) insertion?

Chest drain is inserted into the pleural space for drainage of: • Air in pneumothorax. • Blood in hemothorax. • Fluid in pleural effusion, particularly in malignant effusion. Pus in empyema. • Postoperatively in thoracotomy or cardiac surgery

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