hero-lungs

Thoracic Surgery

Head of Unit

Alessandro Bertani

The Unit provides integrated care programs for all conditions requiring highly specialized surgery on thoracic organs.

During the first outpatient consult, all clinical issues are carefully evaluated, and a personalized plan of care is developed involving anesthesiologists, pulmonologists, cardiologists, and pathologists. Particularly complex cases are reviewed through dedicated multidisciplinary meetings. Thanks to its partnership with UPMC, case discussions also take place remotely through telemedicine systems with specialists from across the UPMC International network.

For several years now, the Unit has been characterized by its expertise in performing complex procedures using minimally invasive techniques. Using advanced instruments and small incisions measuring only a few millimeters, surgeons perform highly-specialized interventions with reduced surgical impact. The Unit serves as a regional referral center for diagnosis and minimally invasive treatment of lung, esophageal, and mediastinal diseases.

Thoracic Cancer Diagnosis and Treatment

Lung Cancer

The Unit is a specialty center recognized by the Sicilian Region for the treatment of lung cancer. Patients with suspected lung cancer undergo histological diagnosis and staging in accordance with international standards of care before proceeding to surgery. Preoperative preparation may be carried out on an outpatient, DH, or inpatient basis.

The diagnostic procedures performed include:

  • Bronchoscopy with bronchial or transbronchial biopsy.
  • Bronchoscopy with endobronchial ultrasound (EBUS) and fine-needle aspiration (FNA) biopsy.
  • CT- or ultrasound-guided biopsy.
  • Mediastinoscopy.

All lung cancer procedures are performed using minimally invasive video-assisted thoracoscopic surgery (VATS). Through small incisions measuring only a few millimeters, this approach provides the same outcomes as conventional open surgery through a thoracotomy, while reducing postoperative pain and allowing a faster recovery.

The average hospital stay following lung resection is only a few days.

Surgical procedures performed for lung cancer include:

  • Minimally invasive (VATS) lung resection with mediastinal lymphadenectomy.
  • Minimally invasive (VATS) pulmonary lobectomy or segmentectomy with mediastinal lymphadenectomy.
  • Minimally invasive (VATS) pneumonectomy with mediastinal lymphadenectomy.
  • Minimally invasive (VATS) pleurodesis.

The same approach is also used to evaluate and treat:

Esophageal cancer

  • Endoscopic and endoscopic ultrasound evaluation (with FNA) of esophageal tumors.
  • Minimally invasive esophagectomy using laparoscopic and thoracoscopic techniques.

    • Mediastinal tumors

      • Thoracoscopic diagnosis of mediastinal tumors.
      • Thoracoscopic thymectomy.

        • Pleural tumors

          • Thoracoscopic diagnosis of pleural diseases.
          • Thoracoscopic pleurodesis.
          • Treatment of mesothelioma, including pleurectomy and extrapleural pneumonectomy.

            • Chest wall tumors

              • Chest wall resection and reconstructive surgery.

Diagnosis and Treatment of Benign Thoracic Diseases

The Unit specializes in the diagnosis and treatment of benign diseases of the esophagus and gastroesophageal junction, including:

  • Gastroesophageal reflux and hiatal hernia.
  • Paraesophageal and diaphragmatic hernias.
  • Achalasia.
  • Zenker’s diverticulum and other esophageal diverticula.
  • Pectus excavatum.

Patients with benign esophageal disorders are assessed and have access to a full range of diagnostic testing.

The surgical procedures performed include:

  • Laparoscopic fundoplication.
  • Laparoscopic esophageal myotomy.
  • Minimally invasive transoral treatment of Zenker’s diverticulum.
  • Resection of mid-esophageal and distal esophageal diverticula.

Myasthenia Gravis

Patients with myasthenia gravis may be evaluated in collaboration with the IRCCS ISMETT Neurology team for bilateral thoracoscopic thymectomy.

Other pathologies

Other conditions that may be treated surgically by the Thoracic Surgery and Lung Transplant Unit include:

  • Pneumothorax.
  • Chest wall and diaphragmatic disorders.
  • Pleural effusions (simple, complex, and empyema).
  • Pulmonary emphysema and emphysematous bullae.
  • Tracheal disorders (tracheal stenosis, tracheoesophageal fistulas).
  • Thyroid disorders.
  • Pericardial diseases (cysts and effusions).

Staff

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