Advances in Thoracic surgery

Dr Arvind Kohli
India has shown alarming increase in the number of pulmonary/thoracic ailments. While ischemic heart disease remains the number one cause of mortality it is alarming to note that three of the six top causes of death are from respiratory diseases. Even in the real of cancer, lung cancer is increasingly being detected and now stands as the foremost cause of cancer mortality among Indian males.
Although the pulmonary diseases are on rise every day the treatment time taken for these are much higher than cardiac ailments Further the number of thoracic surgeons and thoracic care centresfor tackling these problems is much less than the required
Disease called Tuberculosis has high incidence through out India and related complications related to TB need a thoracic surgeons care Chronic infections of the lungs from pneumonia, non-tuberculous mycobacterial (NTM) infections and influenza as well as fungal and bacterial infections can also be extremely serious, leading to pleural collections and subsequently Chronic empyema which are morbid for the patients Keeping in view the high ratio of Pulmonary ailments which require surgical intervention by a dedicated Thoracic surgeon there is a need for bringing up Thoracic surgical care centre to attend to such needy patients
Further with the development in technology the thoracic surgery has shown trends of low morbidity by going minimally invasive Technologies like VATS and Robotics have given good clinical outcomes and early discharge from hospital for patients undergoing major thoracic procedures
Video-assisted thoracic surgery (VATS), a minimally invasive procedure that involves the insertion of a thoracoscope (a tiny camera) and surgical instruments into three small incisions without any spreading of the ribs. This operation is performed under anesthesia in the operating room. The surgeon is able to remove restricting tissue around the lung, insert a drainage tube or apply medicine(Sterile Talc) to reduce fluid accumulation.a procedure called pleurodesis Further it has revolutnized the treatmet of Lung Cancer Thymic malignancies Esophageal cancers Visualisation of mediastinum etc
Robot is an additional tool in the armamentarium of Thoracic surgeons It facilitates the procedure with minimal blood loss and precision The ability of robotic endowrist allows safe conduct of operation by giving better visualization of the operative area Robotic Thoracic platform enhances safety for all major thoracic interventions
Skill Enhancement advent of these modern gadgets which have added safety to thoracic surgery also needs skill enhancement for budding thoracic surgeons for adapting to these thoracic platforms It involves training in operating rooms Workshops and skill labs
One such program under the anvil of Indian Association of Cardiovascular and thoracic surgeons called Thoracic CME program has been arranged by Cardiovascular and thoracic Surgery department of GMC Jammu.The CME which is scheduled for 15th and 16th of November 2019 shall have more than 50 senior thoracic surgeons from leading centers of the country who shall be imparting knowledge as well as skill enhancement through on hand workshops in VATS and Robotic platforms endobronchial ultrasound and Extracorporeal Membrane oxygenation (ECMO) used for bringing out patients of failure of Lung functions In addition there shall be symposium from leading specialist across the surgical field in Lung cancer as well as Lung transplant
More than 100 doctors working in thoracic surgery field along with postgraduate students from all over country as well as Jammu and Kashmir shall be benefitted by participating in this Continuos Medical Education Program
As Matt bellamy has said “In the long term artificial intelligence and automation are going to be taking over so much of what gives humans a feeling of purpose”
(The author is a Consultant CTVS SSH Jammu)