Services

We offer expertise in a wide range of thoracic conditions, including specialized care for complex or rare cases.

Achalasia

We can treat this rare swallowing disorder in multiple ways.

In this motility disorder, the lower esophageal sphincter (LES) doesn’t relax as it should. This leads to esophageal obstruction. Diagnosis includes upper endoscopy, barium swallow, and manometry to measure pressures in the esophagus). We individualize treatment to you, including minimally invasive procedures. Options include expectant management, esophageal dilation, botulinum toxin injections, peroral endoscopic myotomy (POEM), and myotomy. Myotomy may also be performed with an anti-reflux procedure (known as laparoscopic Heller myotomy with Dor fundoplication).

Airway Diseases

Airway disorders are varied and often respond to bronchoscopic intervention.

Airway diseases have many causes and symptoms. A single abnormal area may be caused by an injury, while multiple regions develop as the result of an underlying condition. Symptoms include difficulty breathing, coughing blood, and wheezing. Diagnosis includes chest X-ray, CT scan, and outpatient bronchoscopy. Central airway diseases are treated using interventional pulmonology. We can remove or ablate benign tumors, including bronchoscopic removal for localized tumors.

Carcinoid Tumors

Surgical or bronchoscopic care for this rare tumor leads to long-term survival.

Pulmonary carcinoid tumors are a type of neuroendocrine tumor. Depending on size and location, these tumors are discovered incidentally or when they block the airway. Carcinoid tumors tend to grow locally. When possible, we completely remove them with surgery. Because these tumors are often located in the central airway and can affect a large part of the lung, surgical expertise in lung-sparing surgery, such as sleeve resection, is vital.

Diaphragm Paralysis

Surgical treatment can improve shortness of breath and quality of life.

Your diaphragmatic muscles are the primary muscles of breathing. Loss of nerve function leads to diaphragm paralysis, laxity, and upward elevation in the chest. This elevation makes it hard to breathe. If your breathing is limited, diaphragmatic plication (folding in and tightening of the affected diaphragm) reduces shortness of breath and improves quality of life. We can typically perform this procedure using video-assisted thoracic surgery (VATS).

Endobronchial Valves

Endoscopic treatment of severe emphysema can greatly improve quality of life in select patients.

Bronchoscopic lung volume reduction (BLVR) using one-way endobronchial valves (EBV) may improve quality of life and lung function in select patients with severe emphysema. The minimally invasive procedure places valves in overinflated portions of the lung to block airflow. This creates a controlled collapse and improves respiration. A thorough workup to determine if you might benefit includes pulmonary function testing, CT scan, 6-minute walk test, arterial blood gas, ventilation-perfusion scan, and echocardiogram. Despite the minimally invasive nature of the procedure, complications can occur, but most can be treated.

Esophageal Cancer

This tumor begins the lining of the esophagus and requires aggressive treatment.

Esophageal cancer starts in the inner lining of the esophagus and causes symptoms as it grows. To determine the tumor’s location and size, you may have upper endoscopy with endoscopic ultrasound (EUS), as well as a CT scan and PET scan. Your treatment depends on your tumor stage, location, and your overall fitness, and you may have surgery together with other treatments. We coordinate your care with your gastroenterologist, medical oncologist, and radiation oncologist.

Gastroesophageal Reflux Disease (GERD)

Surgical treatment of severe GERD can improve quality of life.

The excessive backwash of stomach acid into the esophagus causes GERD. An accurate diagnosis of GERD is made using several tests, such as endoscopy, pH probe, esophageal manometry, and contrast X-ray studies. If your symptoms aren't controlled with medications, you may have surgery to tighten the lower esophageal sphincter (LES) to prevent gastric backwash. We perform most anti-reflux surgeries using minimally invasive techniques, allowing rapid recovery.

Hiatal Hernia

Patients with hiatal hernias that cause severe GI or respiratory symptoms should consider repair.

A hiatal hernia is a bulge of the stomach from the abdomen into the chest. You can typically manage a hiatal hernia that causes little to no symptoms with lifestyle changes and anti-reflux medications. But surgery is an option for ongoing symptoms and poor quality of life. During surgery, we pull the stomach back down into the abdomen and tighten the hiatus to prevent a recurrence. We then perform an anti-reflux procedure. We usually use a minimally invasive technique, which helps speed recovery.

Hyperhidrosis

Surgical treatment of severe sweating offers dramatic and lasting results.

Hyperhidrosis causes excessive sweating. While sweating is needed to cool the body, people with hyperhidrosis sweat even when the body does not need it. The most common areas are the feet, face, underarms, or soles of the feet. Treatment ranges from topical treatments, oral medications, botulinum toxin injections, and surgery. If you have severe, unmanaged hyperhidrosis, we offer video-assisted thoracic sympathectomy (VATS). This minimally invasive procedure locally divides nerve fibers in the chest to reduce excessive sweating.

Lung Cancer

This commonly diagnosed cancer requires a thorough workup and prompt treatment.

Lung cancer starts in the lung, but it may grow and spread before causing symptoms. Treatment options have increased remarkably over the last few years, including targeted therapy and immunotherapy. Treatment of lung cancer depends on the stage, and it requires an experienced team. If you have adequate lung function and the physical strength for surgery, surgical removal may be an option for localized disease. Our thoracic surgeon has expertise in lung cancer and minimally invasive techniques.

Lung Cancer Screening

CT scanning in those at high risk for lung cancer saves lives.

Diagnosis of lung cancer in its early stages offers the best chance for cure. Because symptoms typically do not develop until the disease has advanced, screening for lung cancer is key. If you are at high risk for lung cancer, low-dose computed tomography (LDCT) screening can lead to earlier diagnosis and increased survival. LDCT screening is currently an option for patients who have a 20-year or more smoking history, smoke now or quit within the past 15 years, and are between 50 and 80 years old. This non-invasive study takes only minutes to perform.

Lung Nodules and Lung Nodule Clinic

Most lung nodules are benign, but all deserve expert evaluation and close follow-up.

Lung nodules are small growths in the lung. These growths are often found on imaging performed for other reasons and range from 3 to 30 mm in size. Most lung nodules are benign. However, it’s important to discern a benign lung nodule from cancer. All lung nodules require expert evaluation. Through our Lung Nodule Clinic, we offer an extensive workup by a thoracic specialist and long-term follow-up.

Lung Volume Reduction Surgery (LVRS)

Surgical removal of diseased lung in severe emphysema improves breathing and survival in some patients.

LVRS can improve breathing and increase survival in select patients with emphysema and severe COPD. LVRS removes lung tissue at the top of the lungs that has been destroyed by emphysema. Removal of this tissue allows recontouring of the chest and improved diaphragmic function. This may increase your quality of life and help you live longer. LVRS is performed using minimally invasive video-assisted thoracic surgery (VATS), which can provide a faster recovery.

Malignant Mesothelioma

Surgery can extend life and improve its quality for patients with this rare tumor.

Malignant pleural mesothelioma is a type of cancer in the lining of the chest. While the condition can start in other locations, pleural represents the majority. The tumor is rare and impacts only about 3,000 Americans per year. Most cases are related to workplace exposure to asbestos that occurred decades earlier. Treatment varies and includes chemotherapy, immunotherapy, targeted therapy, radiation therapy, and surgery, depending on your cancer stage and overall physical condition. Given the rarity of the tumor, you should seek care from an experienced center.

Myasthenia Gravis (MG)

This disorder is caused by a breakdown in communication between nerves and muscles and may be improved by surgery in some patients.

MG is an autoimmune disorder. It's caused by antibodies that destroy the communication between nerves and muscles. Medications that suppress the immune response are usually effective, depending on the severity of the disease. If medications are not effective, surgery can be helpful. The thymus gland is located behind the breastbone, and its removal may help select patients with MG. We typically use a minimally invasive approach for this procedure (thymectomy).

Pectus Excavatum

Chest wall abnormalities can cause psychological distress and functional impairment.

Pectus excavatum is a condition where the front portion of the chest sinks or protrudes. It’s usually seen in children in their early teens when skeletal changes are rapid. An unbalanced growth of cartilage that connects the ribs to the bony sternum causes the condition. Treatment depends on patient age, the severity of the pectus, and symptoms. We offer surgery for severe cases, but most patients do not need surgery.

Pleural Effusion

We can treat this common disorder quickly using a minimally invasive procedure.

A pleural effusion is a fluid collection between the two layers (pleura) that line the chest. It's common and is caused by a wide variety of medical problems, most of which are benign. Diagnosis is made by chest X-ray, CT scan, or ultrasound. Your treatment options include medical management with close observation, needle drainage (thoracentesis), and surgery. If needed, we provide video-assisted thoracic surgery (VATS) for treatment.

Pulmonary Metastases

Tumors that start in other parts of the body can spread to the lung. Surgical removal may extend life or lead to a higher rate of cure.

Cancer that spreads to the lung (pulmonary metastasis) is common but rarely causes symptoms. It can be treated with chemotherapy, immunotherapy, targeted therapy, radiofrequency ablation, and stereotactic body radiation (SBRT). If you have a limited number of metastases localized to the chest, surgical removal of the tumors can improve survival. Your team of physicians will decide if this option is right for you.

Robotic Surgery

Robotic surgery allows a minimally invasive approach with more rapid recovery in some patients.

Robotic thoracic surgery is a form of minimally invasive surgery. It’s used within the chest to perform a variety of operations that once required larger incisions or open surgery. During robotic surgery, our surgeon operates from a console located within the operating room using 3D optics and specialized instruments.

Thoracic Outlet Syndrome (TOS)

We can relieve compression of nerves and blood vessels between the collarbone and first rib with surgery.

TOS happens when the blood vessels or nerves between the collarbone and first rib (thoracic outlet) are compressed. This leads to pain, weakness, or swelling in the arm or shoulder. Compression of the nerves is the most common condition. Causes include trauma and repetitive motion injuries from sports or work. Diagnosis can be difficult and is usually made by a neurologist with an experienced TOS surgeon. TOS responds well to physical therapy. However, you may need surgery to relieve the compression.

Thymoma

This rare tumor starts in the thymus gland and often requires surgical removal.

Thymoma and thymic carcinoma are forms of cancer that affect the thymus gland. This small organ is located behind the breastbone. It aids in T-cell immunity during childhood but plays little role in adulthood. Many thymomas are small and found on imaging performed for other reasons. Your care depends on the tumor’s size, location, and growth. A biopsy is sometimes needed before surgical removal. This can often be performed using minimally invasive techniques, such as VATS or robotic thoracic surgery.

Tracheal Resection

Narrowing of the windpipe can lead to severe shortness of breath, which we can relieve with surgery.

Severe tracheal stenosis (narrowing) can affect breathing and become a life-threatening emergency. Some patients need surgery to remove the narrowed portion of the trachea (tracheal resection). This depends on the severity, length, and location and if there are other effective treatment options. Tracheal resection requires an experienced surgeon, anesthesia, and critical care team. The procedure can provide lasting relief from symptoms.

Tracheal Stenosis

Narrowing of the windpipe can produce severe symptoms and has many treatment options.

Prolonged or traumatic intubations may cause tracheal stenosis. But some cases develop with no clear cause. Typically, you can be treated with minimally invasive techniques, including bronchoscopy, balloon dilation, or thermal ablation. Occasionally, a T-tube, airway stent, or tracheostomy is needed to maintain the airway opening. To personalize your care, our experienced thoracic surgeon and care team offer all types of therapy.

Video-Assisted Thoracic Surgery (VATS)

This minimally invasive technique reduces pain after surgery and allows more rapid recovery.

VATS is a form of minimally invasive surgery. It’s used within the chest to perform procedures that previously required larger incisions and rib spreading (thoracotomy). Our thoracic surgeon operates using small incisions between the ribs, a small telescope (thoracoscope) to see within the chest, and small, specially designed instruments. We perform most thoracic surgery using VATS, including removal of a lobe of the lung, allowing more rapid recovery with less pain.