Thoracic Procedures

Surgical interventions to manage diseases of the thorax require thoracic procedures. It involves surgeries of the lungs, diaphragm, windpipe (trachea), esophagus, pleural space, mediastinum, and chest wall. As the thoracic cavity has vital organs, such as the lungs and heart, several conditions require immediate medical intervention.

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  • Conditions
  • Thoracic Trauma: Thoracic trauma includes penetrating and blunt trauma. Motor vehicle collisions are the main cause of thoracic trauma. The other causes include violence (physical assault), blasts, falls, and motor vehicle accidents.
  • Empyema: The pleural cavity is the space between the chest cavity and the lungs. The presence of pus in this space is known as empyema. It is generally caused when the lung infection spreads to the pleural space.
  • COPD: Chronic Obstructive Pulmonary Disease (COPD) causes breathing problems due to restricted airflow. It includes chronic bronchitis and emphysema. Patients with COPD experience chest tightness, fatigue, and wheezing.
  • Lung Fibrosis: Lung fibrosis is characterized by scarred and damaged lung tissues. Smoking, exposure to harmful dust or fumes, and advanced age are risk factors for pulmonary fibrosis.
  • Benign Lung Diseases: Several benign nodules or tumors are found in the lungs. These are non-cancerous and not life-threatening. Types of benign lung tumors are hamartomas, papillomas, bronchial adenomas, and fibromas.
  • Pleural Diseases: The pleura or pleural tissue lines inside the chest cavity and outside of the lungs. The pleural disorders include pleurisy, pneumothorax, and pleural effusion.
  • Diaphragm Disorders: Several diseases affect the diaphragm. These include diaphragmatic dysfunction, diaphragm paralysis, and diaphragm hernia.
  • Chest Wall Disorders: Chest wall disorders comprise congenital disorders of the chest present at birth and acquired chest disorders caused due to illness or injuries. The congenital chest disorders include pectus carinatum and pectus excavatum.
  • Procedures
  • Pneumonectomy: This surgical procedure involves the removal of one entire lung due to trauma, cancer, or other conditions.
  • Lobectomy: Three lobes are present in the right lung and two in the left lung. The removal of a damaged lobe is known as lobectomy.
  • Decortication: This surgical intervention removes the fibrous tissue abnormally developed on the surface of the chest wall, lung, or diaphragm.
  • Thoracoscopy: Thoracoscopy is a diagnostic procedure performed to evaluate the health of the chest cavity, including the pleural space.
  • Uniport VATS: Uniport video-assisted thoracoscopic surgery is a minimally invasive surgery that involves creating only a single incision between the ribs to access the lungs. It.


Thoracic procedures refer to surgical interventions performed in the chest cavity, specifically addressing conditions related to the lungs, pleura (lining of the lungs), diaphragm, and chest wall. These procedures aim to diagnose, treat, or manage various thoracic disorders.

Thoracic trauma refers to injuries sustained by the chest area due to accidents or other traumatic events. These injuries can involve the ribs, lungs, heart, blood vessels, and other structures in the chest. Thoracic procedures may be necessary for evaluating and treating such trauma.

Empyema is a condition characterized by pus accumulation within the pleural space surrounding the lungs. It often occurs as a complication of pneumonia or lung infections and may require drainage through thoracic procedures for effective treatment.

While medical management forms the primary approach for COPD and lung fibrosis treatment, certain cases may require surgical intervention when conservative measures fail to provide relief or complications arise. Surgical options include lung volume reduction surgery (LVRS) for COPD patients with severe symptoms and lung transplantation for advanced cases of both diseases.

Benign lung diseases that could potentially require thoracic procedures vary widely but commonly include pulmonary nodules/masses requiring biopsy or resection; bronchiectasis causing recurrent infections; bullous disease leading to air leakage; or congenital malformations affecting normal lung function.

Thoracoscopy can help diagnose and treat several pleural conditions like pneumothorax (collapsed lung), hemothorax (blood accumulation in the pleural space), pleural effusion (abnormal fluid collection), or pleural infections. Thoracic procedures aid in drainage, biopsy, and other necessary interventions.

Thoracic procedures play a crucial role in managing diaphragm disorders such as diaphragmatic hernias or paralysis. Surgical repair of hernias or plication to restore normal function may be required, while nerve stimulation techniques can help address diaphragmatic paralysis.

Chest wall disorders encompass a range of conditions like rib fractures, tumors/masses affecting the chest wall, or congenital deformities requiring surgical correction through thoracic procedures for pain relief, stabilization, removal of masses/tumors, or aesthetic reconstruction.

The surgical procedures for lung cancer are segmental resection (removal of a lung segment), wedge resection (removal of a triangle-shaped segment of the lung), lobectomy (removal of one complete lobe of the lung), and pneumonectomy (removal of the lung).

Surgery is required in pectus excavatum when the patients present with clinical features of severe deformity, cardio-respiratory compromise, and excessive sternal depression (inward growth of the sternum).