Home | News | Donate | Directions | Careers

Thoracic Surgery


Treatments

The Division of Thoracic Surgery serves patients and their families with a common goal to treat the condition and lead the patient on as comfortable a path to recovery as  possible. The patient will be treated in state-of-the-art facilities using a multidisciplinary approach. The staff of compassionate diagnosticians, surgeons, and nurse practitioners work collaboratively to provide patients with the most advanced and effective medical treatment and unmatched patient care.

The advanced surgical treatments  offered include:

Bullectomy

Bullectomy is the surgical removal of a bulla, which is an air pocket in the lung that is greater than one centimeter in diameter.

A patient may experience:

  • Pressure in the chest
  • Difficulty breathing
  • Soreness
  • A bloated feeling
  • Fatigue

Bullae are often diagnosed with X-rays or computed tomography (CT) scans. Bullectomy is typically not a cure for the cause of the bulla, but may greatly improve symptoms.

How to Prepare?

It is important to follow any instructions given to you by your physician to prepare for surgery. These generally include not eating or drinking anything after midnight on the night before surgery, bringing all medications with you to the hospital, and arriving one hour before surgery.

You may have a pre-admission appointment one to two weeks beforehand, during which you will have routine blood tests; any heart, lung, or esophageal imaging; and a consultation with the anesthesiologist, who will administer medicine during your procedure that puts you to sleep and eases pain. 

If possible, do some mild physical activity, such as walking, and eat a balanced diet leading up to scheduled surgery. In the week before, follow the guidelines below:

  • Limit alcohol consumption to one to two glasses a day.
  • Stop using tobacco or cut back on the number of cigarettes smoked each day.
  • Make a list of all medications you take and bring it with you to the hospital. Include prescription and over-the-counter medications, herbs, supplements, aspirin and corticosteroids on your list.

What to Expect?

On the day before your procedure, you should receive a call from the hospital. You will be given information about the day of your bullectomy, including where to go and when to arrive. Leave jewelry, credit cards, or other valuables at home, and wear comfortable clothes.

When you arrive, you will be taken to a pre-surgery area so that we can take your temperature, blood pressure, pulse, and listen to your heart and lungs. We will place an intravenous (IV) line in your arm, so that medications and fluids may be administered before, during, and after the procedure, and the anesthesiologist will give you medicine to fall asleep.

Bullectomy is often done by means of a thoracotomy, in which a four- to six-inch incision is made, usually below your armpit, or by video thoracoscopy, where small incisions are made on the side of your chest. A thin, lighted tube called a thoracoscope as well as surgical tools are inserted through catheters. In video thoracoscopy, a video screen and console guides the surgeon as he or she removes the bulla. Once it is removed, your surgeon will close the incision(s).

What is the Recovery Process?

After surgery, you will be taken to the Post Anesthesia Unit and monitored for any changes in blood pressure, heart rate, and breathing. An IV line will remain in your arm to keep you hydrated and provide pain medication, if necessary. If a breathing tube was inserted during surgery to control your breathing, it may stay in place for a brief time. Your stay with us may last one night or more, depending on the healing process and the procedure.

Before you go home, your physician or nurse will teach you how to care for your incision. Gradually, over a few weeks, you will regain your strength and be able to return to work and participate in physical activity.

Be sure to call your doctor if you notice any of the following:

  • Bleeding
  • Infection
  • High temperature
  • Allergic reaction, such as redness, swelling, or trouble breathing
  • Pain

Always take your medicine exactly as prescribed, and be sure to call us if you have any questions or changes.

Minithoracotomy

Open operations for thoracic diseases are usually performed using an incision called a thoracotomy. This is an incision made in the side of the chest between the ribs. Minithoracotomy is another approach that can be used in some instances – a small incision is made to decrease pain and scarring, and improve recovery time.

How to Prepare?

It’s important to follow the instructions your physician gives you to prepare for surgery. They generally include:

  • Not eating or drinking anything after midnight on the night before your procedure
  • Bringing a list of your medications with you to the hospital
  • Arriving at least one hour before surgery

You may have a pre-admission appointment before your procedure, during which you’ll have routine blood tests and you’ll speak with the anesthesiologist who will give you medicine during your procedure that will put you to sleep and ease pain.

If possible, do some mild physical activity, such as walking, and eat a balanced diet before scheduled surgery. In the week before, try to:

  • Limit alcohol consumption to one to two glasses a day.
  • Stop using tobacco.
  • Make a list of all your medications and bring it with you to the hospital. Include prescription and over-the-counter medications, herbs, supplements, aspirin, and corticosteroids.

What to Expect?

Before your procedure, you should receive a call from the hospital. You will be given information about the day of your surgery, including where to go and when to arrive. When you arrive, you will be taken to a pre-surgery area so that we can take your temperature, blood pressure, and pulse, and listen to your heart and lungs. We will place an intravenous (IV) line in a vein in your arm, so that medications and fluids may be given to you before, during and after the procedure.

What is the Recovery Process?

After surgery, you will be taken to the Post Anesthesia Unit and monitored for any changes in blood pressure, heart rate, and breathing. An IV line will remain in the vein in your arm to keep you hydrated and to provide pain medication, if necessary. If a breathing tube was inserted during surgery to control your breathing, it may stay in place for a brief time.

Before you go home, your physician or nurse will teach you how to care for your incision. Over the next few days you will regain your strength and be able to return to work and participate in physical activity.

Be sure to call your doctor if you notice any of the following:

  • Bleeding
  • Infection
  • High temperature
  • Allergic reaction, such as redness, swelling, or trouble breathing
  • Pain

Always take your medicine exactly as prescribed. Call us if you have any questions or changes.

Pleurodesis

Overview

Pleurodesis is a therapy that we offer lung cancer patients to remove excess fluid, called pleural effusion, from the space between the lungs and chest wall that lines the lungs, or pleura. This fluid prevents the lungs from fully expanding when a person breathes, causing shortness of breath. Pleural effusion is usually diagnosed using chest X-ray; a sample of the fluid may be taken to confirm its cause. The pleurodesis is performed through a video-assisted thoracoscopy, a new, less invasive approach.

If the procedure isn’t successful, it may be repeated. Pleurodesis doesn’t treat lung cancer, but it can be very helpful in reducing symptoms.

How to Prepare?

It’s important to follow any instructions your physician gives you to prepare for the procedure. In general instructions include:

  • Not eating or drinking anything after midnight on the night before your procedure
  • Bringing a list of all your prescription and over-the-counter medications, herbs, and supplements with you to the hospital
  • Arriving at the hospital one hour before your procedure

You may have a pre-admission appointment before your procedure, during which you’ll have routine blood tests, any necessary imaging and a talk with the anesthesiologist who will give you medicine during your procedure that will put you to sleep and ease pain.

What to Expect?

We will place an intravenous (IV) line in a vein in your arm, so that medications and fluids can be given to you before, during, and after the procedure. Once we have given you anesthesia and you are asleep, the surgeon will make one or two small incisions in your side and insert the thoracoscope. Other instruments are inserted into the other incisions.

This allows your surgeon to view the area in your chest on a monitor and guide the use of tools so that the fluid can be removed. We will then blow or spray a talc solution evenly over the lung and pleural surfaces. Your surgeon will remove the tools once this is finished and close the incisions. We’ll leave a tube in your chest for a day or two so that all of the fluid can drain. 

What is the Recovery Process?

Once the procedure is completed, a dressing is put over the incisions. It should remain in place for 24 to 48 hours.

We will give you instructions to care for your incision and prescribe or recommend pain medication, if necessary. Because anti-inflammatory drugs can prevent the irritation necessary for the treatment of pleural effusion, avoid using them for as long as your doctor advises.

You will have a follow-up appointment soon after your procedure, but call us in the meantime if you have concerns.

Appointments

Call: 617.638.5600
Fax: 617.638.7382


Boston Medical Center
Center for Thoracic Surgery
Moakley Building
830 Harrison Avenue, 3rd Floor
Boston, MA 02118


Refer a Patient

Call: 617.638.5600
Fax: 617.638.7382


Administrative Office

88 East Newton Street
Robinson B-402
Boston, MA 02118
Call: 617.638.5600
Fax: 617.638.7382


Learn More

Quick Links

Directions to BMC
BMC Campus Virtual Tour
BU School of Medicine, Surgery
Center for Thoracic Oncology
Center for Minimally Invasive Esophageal Therapies

Downloads (PDF)

BMC Campus Map
What Makes BMC Special