Advanced thoracic surgery care
Specialists at Ascension Saint Thomas Medical Partners Midtown and West Chest and Lung Center in Nashville, Tennessee, have the expertise to deliver surgical care for your esophagus, lungs, ribs and chest wall disorders to manage pain, treat cancer, and improve breathing and swallowing. Our thoracic surgeons surgically treat common to complex conditions – from chest wall, airway and rib traumatic injuries to repairing diaphragm hernias in the upper abdomen and reconstructing the esophagus for cancer.
Comprehensive care by an integrated care team
At Ascension Saint Thomas, we believe in a team approach to care. Dr. John Lazar leads an experienced team of board-certified thoracic surgeons. They have expertise in specialized surgical techniques using image-guided technology and minimally invasive procedures. Our thoracic surgeons are part of an integrated care team that includes radiologists, pathologists, pulmonologists, gastroenterologists, oncologists, nurse practitioners, physician assistants, nurses, nutritionists, respiratory therapists, pharmacists, physical therapists, and occupational therapists. Our team collaborates to provide personalized care that focuses on you.
Thoracic surgery, also known as chest surgery, encompasses procedures involving the organs and structures within the chest cavity, including the esophagus, trachea, and chest wall. At Ascension Saint Thomas, we provide a wide range of surgical procedures, including but not limited to:
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Airway reconstructionAirway reconstruction is a surgical procedure to widen a narrowed windpipe, making it easier to breathe and improving airflow. Conditions that can cause airway narrowing: adult tracheal stenosis and childhood tracheomalacia.
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Bleb resectionBleb resection using thoracotomy, video-assisted thoracoscopic surgery (VATS) and minimally invasive endoscopic surgery treats the recurrence of pneumothorax, a condition where air accumulates in the space between the lungs and the chest wall. During the procedure, the surgeon removes small air-filled sacs on the surface of the lung. Our surgical approach helps restore normal lung function and prevent a collapsed lung.
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Carinal resectionCarinal resection treats conditions affecting the airway, including non-small cell lung cancer. The surgeon removes a portion of the carina, which is the point where the trachea splits into the left and right main bronchi. In some cases, lung tissue may also be removed along with the carinal resection. This surgery aims to remove the affected tissue and restore proper airflow through the airway, helping to alleviate symptoms and improve overall lung function.
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Chest resection and chest wall reconstructionSurgical procedures are performed to treat conditions affecting the chest wall (tumors, infections, trauma, and radiation). During chest resection, the surgeon removes part or all of the soft tissue, cartilage, sternum, or ribs that are affected by the condition. Following chest resection, chest wall reconstruction is often necessary to restore the structural integrity of the chest wall. This may involve using artificial bone or titanium rib plating to rebuild the skeletal structure. The decision to perform reconstruction depends on factors such as the extent of tissue removal, cosmetic concerns, and the potential for respiratory complications.
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DecorticationDecortication is a surgical procedure used to remove fibrous tissue (pleural peel) that has abnormally formed on the surface of the lung, chest wall or diaphragm, usually from a prior infection or chronic fluid buildup around the lung. Fibrous tissue can restrict lung expansion and cause breathing difficulties. By removing this tissue, decortication helps improve lung function and alleviate symptoms such as shortness of breath and chest pain.
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Diaphram plicationDiaphragm plication is a surgical procedure used to treat conditions such as diaphragmatic eventrations or paralysis that affect respiratory function. During the procedure, the surgeon reshapes the diaphragm by suturing any extra muscle to help expand lung capacity and, therefore, improve breathing.
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Diaphramatic hernia repairDiaphragmatic hernia repair is a surgical procedure to treat a diaphragmatic hernia, a condition where abdominal organs protrude into the chest cavity through a hole or weak spot in the diaphragm. The surgeon places the abdominal organs back into their proper position and repairs the opening in the diaphragm. This helps prevent complications, such as organ strangulation, and restores normal function to the diaphragm to help improve respiratory function.
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VATS thoracic sympathectomy to manage excessive sweatingVATS thoracic sympathectomy is a surgical procedure used to treat excessive sweating (hyperhidrosis) of the hands, feet, armpits, or face. The surgeon accesses the sympathetic nerves responsible for sweating through small incisions in the chest and uses specialized tools to interrupt or remove a portion of these nerves. The procedure disrupts the nervous system signals and helps reduce sweating.
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Esophageal diverticulectomyEsophageal diverticulectomy is a surgical procedure used to treat esophageal diverticula, pouch-like protrusions that develop in the lining of the esophagus. The surgeon removes the diverticulum to alleviate symptoms such as difficulty swallowing, regurgitation of undigested food and chest pain. Esophageal diverticulectomy aims to improve the passage of food and fluids through the esophagus and alleviate discomfort associated with the diverticulum.
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FundoplicationFundoplication is a surgical procedure to help relieve stomach juices from refluxing back up the esophagus. The surgeon wraps part of the stomach, called the fundus, around the base of the esophagus to reinforce the sphincter to help relieve inflammation.
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EsophagectomyEsophagectomy is a surgical procedure to remove part or all of the esophagus. It's often done to treat conditions such as esophageal cancer, severe Barrett's esophagus, or end-stage achalasia (a swallowing disorder). After removing the affected portion, the remaining esophagus is reconstructed using tissue from elsewhere in the body, usually the stomach.
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Hiatal hernia repair using the Besley Mark IV operationA hiatal hernia occurs when part of the stomach bulges into the chest. Surgical repair involves pulling the stomach down into the abdomen and making the opening in the diaphragm smaller. During the procedure, the surgeon may reshape the muscles of the lower esophagus to help keep the contents of the stomach from coming back up (called reflux).
-
Airway reconstructionAirway reconstruction is a surgical procedure to widen a narrowed windpipe, making it easier to breathe and improving airflow. Conditions that can cause airway narrowing: adult tracheal stenosis and childhood tracheomalacia.
-
Bleb resectionBleb resection using thoracotomy, video-assisted thoracoscopic surgery (VATS) and minimally invasive endoscopic surgery treats the recurrence of pneumothorax, a condition where air accumulates in the space between the lungs and the chest wall. During the procedure, the surgeon removes small air-filled sacs on the surface of the lung. Our surgical approach helps restore normal lung function and prevent a collapsed lung.
-
Carinal resectionCarinal resection treats conditions affecting the airway, including non-small cell lung cancer. The surgeon removes a portion of the carina, which is the point where the trachea splits into the left and right main bronchi. In some cases, lung tissue may also be removed along with the carinal resection. This surgery aims to remove the affected tissue and restore proper airflow through the airway, helping to alleviate symptoms and improve overall lung function.
-
Chest resection and chest wall reconstructionSurgical procedures are performed to treat conditions affecting the chest wall (tumors, infections, trauma, and radiation). During chest resection, the surgeon removes part or all of the soft tissue, cartilage, sternum, or ribs that are affected by the condition. Following chest resection, chest wall reconstruction is often necessary to restore the structural integrity of the chest wall. This may involve using artificial bone or titanium rib plating to rebuild the skeletal structure. The decision to perform reconstruction depends on factors such as the extent of tissue removal, cosmetic concerns, and the potential for respiratory complications.
-
DecorticationDecortication is a surgical procedure used to remove fibrous tissue (pleural peel) that has abnormally formed on the surface of the lung, chest wall or diaphragm, usually from a prior infection or chronic fluid buildup around the lung. Fibrous tissue can restrict lung expansion and cause breathing difficulties. By removing this tissue, decortication helps improve lung function and alleviate symptoms such as shortness of breath and chest pain.
-
Diaphram plicationDiaphragm plication is a surgical procedure used to treat conditions such as diaphragmatic eventrations or paralysis that affect respiratory function. During the procedure, the surgeon reshapes the diaphragm by suturing any extra muscle to help expand lung capacity and, therefore, improve breathing.
-
Diaphramatic hernia repairDiaphragmatic hernia repair is a surgical procedure to treat a diaphragmatic hernia, a condition where abdominal organs protrude into the chest cavity through a hole or weak spot in the diaphragm. The surgeon places the abdominal organs back into their proper position and repairs the opening in the diaphragm. This helps prevent complications, such as organ strangulation, and restores normal function to the diaphragm to help improve respiratory function.
-
VATS thoracic sympathectomy to manage excessive sweatingVATS thoracic sympathectomy is a surgical procedure used to treat excessive sweating (hyperhidrosis) of the hands, feet, armpits, or face. The surgeon accesses the sympathetic nerves responsible for sweating through small incisions in the chest and uses specialized tools to interrupt or remove a portion of these nerves. The procedure disrupts the nervous system signals and helps reduce sweating.
-
Esophageal diverticulectomyEsophageal diverticulectomy is a surgical procedure used to treat esophageal diverticula, pouch-like protrusions that develop in the lining of the esophagus. The surgeon removes the diverticulum to alleviate symptoms such as difficulty swallowing, regurgitation of undigested food and chest pain. Esophageal diverticulectomy aims to improve the passage of food and fluids through the esophagus and alleviate discomfort associated with the diverticulum.
-
FundoplicationFundoplication is a surgical procedure to help relieve stomach juices from refluxing back up the esophagus. The surgeon wraps part of the stomach, called the fundus, around the base of the esophagus to reinforce the sphincter to help relieve inflammation.
-
EsophagectomyEsophagectomy is a surgical procedure to remove part or all of the esophagus. It's often done to treat conditions such as esophageal cancer, severe Barrett's esophagus, or end-stage achalasia (a swallowing disorder). After removing the affected portion, the remaining esophagus is reconstructed using tissue from elsewhere in the body, usually the stomach.
-
Hiatal hernia repair using the Besley Mark IV operationA hiatal hernia occurs when part of the stomach bulges into the chest. Surgical repair involves pulling the stomach down into the abdomen and making the opening in the diaphragm smaller. During the procedure, the surgeon may reshape the muscles of the lower esophagus to help keep the contents of the stomach from coming back up (called reflux).
Advanced care for lung and breathing disorders
When you choose Ascension Saint Thomas for your surgical care, you get a multispecialty thoracic and interventional pulmonary medicine care team dedicated to your care. These specialists work closely with radiologists and oncologists to deliver advanced care for lung, esophagus and chest disorders. Our experienced doctors use advanced 3D image-guided surgical technology and minimally invasive techniques to diagnose, stage and treat cancer and benign tumors. Our thoracic surgeons have access to CYTALUX®, the only FDA-approved fluorescent imaging technology to light up lung cancer tumors, improve visualization during surgery and help define surgical margins. The lung and chest cancer care team at Ascension Saint Thomas includes:
Hematology - medical oncology
- Oncologists provide advanced medication treatments, including chemotherapy, hormone therapy, targeted therapy, and immunotherapy for lung and chest cancers.
Tumor board
- Our tumor board represents multidisciplinary specialists. They discuss precision medicine, innovative tests and therapeutic cancer treatment options that are personalized for you.
Pulmonary rehabilitation
- Pulmonary rehabilitation is an outpatient supervised program that includes exercise, health maintenance and breathing techniques to help improve respiratory function.
Radiation oncology
- Advanced radiation therapy is used to target and destroy cancer cells while avoiding the surrounding healthy tissue.
Clinical trials in thoracic surgery and lung cancer
Dr. John Lazar is the Chief of Thoracic Surgery and Oncology at Ascension Saint Thomas. He is a principal investigator in several clinical trials investigating new methods to diagnose and treat lung and chest wall cancer using surgical diagnostic tests and procedures. To refer a patient and schedule a surgical consultation with Dr. Lazar, call 615-329-7878.
Find out more about thoracic lung and chest services at Ascension Saint Thomas.
Find out more about pulmonary care at Ascension Saint Thomas