Thoracic Surgery in India

Overview

Thoracic surgery is the treatment and study of diseases of the chest or thorax, including lungs, heart, blood vessels and chest wall that require surgical operation for diagnosis and/or treatment. Other organs on which thoracic surgery is performed include, trachea, esophagus, mediastinum and diaphragm. Thoracic surgeons may include congenital heart, cardiovascular and cardiothoracic surgeons. The most common diseases requiring thoracic surgery include lung cancer, chest trauma, esophageal cancer, emphysema, and lung transplantation.

Preparation for Thoracic Surgery

• Except in the case of emergency procedures, candidates for general thoracic surgery should undergo a complete medical history and thorough physical examination prior to surgery
• Particular attention is given to the respiratory system
• The patient's smoking history will be questioned. If the patient is an active smoker, encouragement is always given for the patient to quit smoking prior to the surgery to facilitate recovery and reduce chances of complications
• Diagnostic tests used to evaluate the patient preoperatively may include, but are not limited to, x rays, MRI, CT scans, blood gas analysis, pulmonary function tests, electrocardiography, endoscopy, pulmonary angiography, and sputum culture
• Patients are instructed not to eat 10 to 12 hours prior to a thoracic surgery procedure

Thoracic Surgery Procedures

Thoracic Surgical and diagnostic procedures include:

• VATS Lobectomy
• Thoracoscopic lung resection
• Thoracoscopic evaluation and management of pleural space
• Thoracoscopic mediastinal biopsy
• Thoracoscopic resection of mediastinal masses
• Thoracoscopic Staging

The surgeon may use two common incisional approaches: sternotomy (incision through and down the breastbone) or via the side of the chest (thoracotomy). An operative procedure known as video assisted thoracoscopic surgery (VATS) is minimally invasive. During VATS, a lung is collapsed and the thoracoscope and surgical instruments are inserted into the thorax through any of three to four small incisions in the chest wall. Another approach involves the use of a mediastinoscope or bronchoscope to visualize the internal anatomical structures during thoracic surgery or diagnostic procedures.

Types of Thoracic Surgery

The most basic and generalized type, general thoracic surgery involves the treatment of lung diseases, tumors, cancers, and transplants as well as esophageal problems and gastroesophageal reflux.

• Mesothelioma - Mesothelioma is a rare form of cancer that develops from the protective lining that covers many of the internal organs like liver, lung, etc. It is diagnosed with the help of Thoracoscopy besides other evaluation methods. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples. Alternatively, the chest surgeon might directly open the chest (thoracotomy).
• Lung Transplantation - There are various types of lung transplantations: unilateral (one lung; most common type); bilateral (both lungs); heart-lung; and living donor lobe transplantation. Thoracic surgery plays a significant role in lung transplantation.
• Chest Trauma - Chest trauma is a medical/surgical emergency. Patients with respiratory distress require endotracheal intubation (passing a plastic tube from the mouth to the windpipe) and mechanically assisted ventilator support. Invasive thoracic procedures are necessary in emergency situations. Trauma requiring urgent thoracic surgery may include any of the following problems: a large clotted hemothorax, massive air leak, esophageal injury, valvular cardiac injury, proven damage to blood vessels in the heart, or chest wall defect.
• Esophageal Cancer - Over 90% of patients with esophageal squamous cell carcinoma develop the tumor in the upper and middle thoracic esophagus. The standard operation for patients with resectable esophageal carcinoma includes removal of the tumor from the esophagus, a portion of the stomach, and the lymph nodes (within the cancerous region). These tumors are removed by the surgeons through thoracic surgery.
• Soft Tissue Sarcoma - Thoracic surgery is also needed to cure soft tissue sarcoma.Though these tumors can form in any part of the body but they are more common in the arms, abdomen, legs and trunks Emphysema - LVRS or Lung volume reduction surgery is the term used to describe surgery for patients with emphysema. Surgery will assist the patient, but the primary pathogenic process that caused the emphysema is permanent because lung tissues lose the capability of elastic recoil during normal breathing.
• Lung Cancer - Lung surgery for cancer includes the removal of the tumor, lymph nodes and sections of the lung that contain the tumor. Thoracic Surgery is the treatment of choice in several types and stages of lung cancer, either alone, or in combination with chemotherapy or radiation therapy. Surgical approach includes Thoracoscopy (VATS-Video Assisted Thoracic Surgery). If the tumor is not accessible with the thoracoscope Thoracotomy is used.

Follow Up Care Post Thoracic Surgery

After surgery, the patient is taken to the recovery room, where vital signs are monitored; depending on the procedure performed, the breathing tube may be removed. Patients typically experience moderate to severe pain after surgery, and are given pain medications. In uncomplicated cases, chest and urine tubes or catheter are usually removed within 24–48 hours.

The hospital stay for thoracic surgery depends on the specific procedure performed. Patients who undergo a thoracotomy may be hospitalized a week or longer, while patients undergoing VATS typically have a shorter hospital stay of 2-3 days. During the recovery period, respiratory therapists and nurses work with the patient on deep breathing and coughing exercises to improve lung function.

Benefits of Thoracic Surgery

If minimally invasive surgical techniques for thoracic surgery are used, there is usually less blood loss, decreased amount of postoperative pain, and a shorter hospital stay. Also, very important is the fact that patients usually regain their level of function they had prior to the surgery much sooner, in comparison to those patients undergoing traditional open thoracic surgery techniques. In the average scenario, a patient can be fully-recovered and return to everyday physical activities within six to eight weeks, depending on his or her age and overall health. If the doctor recommends thoracic surgery robotic surgery or laparoscopy can be considered which offers numerous potential benefits over a conventional surgery, including Less risk of infection, Significantly less pain, Less scarring, Better clinical outcomes, in many cases, etc.

Thoracic Surgery in India

India has a pool of internationally trained surgeons that deal with general thoracic surgery and cardiothoracic surgery. Many hospitals in India provide non-invasive diagnostic exam that has enhanced level of visual imaging. This improves the chances of accurate diagnosis. India is the most popular destination for patients with lung cancer, chest trauma, esophageal cancer, emphysema, and lung transplantation. India offers comprehensive "one stop service" that includes diagnostic tools, medical treatment, nutrition support and surgical treatment when indicated.

Cities in India that offers Thoracic Surgery at some of the best hospitals are as follows;

Cost of Thoracic Surgery in India

India is the most reasonable medical tourist destination for Thoracic Surgery. The cost of treatment and surgery is extremely less. Thoracic surgery is readily available in most cities of India at a very economical price. The cost of transportation and accommodation is also highly feasible. Many people, every year, avail the benefits of having the low cost thoracic surgery in India and end up saving a lot of money.

Some of the common countries from which patients travel to India for surgery are:

ABOUT INDIA

Located in South Asia, bordered by Pakistan, Nepal, China and Bangladesh, India is South Asia's largest, sovereign, democratic republic. India has an edge over other countries when it comes to offering comprehensive, cost-effective and timely medical care: it also offers an exotic, adventure-filled or cultural -if you wish array of destinations to discover and revel in for the travelers. Indian cities like Mumbai, Hyderabad, Goa, Bangalore, Nagpur, Kerala, Delhi, Pune, Jaipur, Chennai, Gurgaon, and Chandigarh offers best medical tourism service.

• Mumbai - Formerly known as Bombay, is the commercial & financial capital city of India. Mumbai is famous for many things, including its thriving Bollywood film industry, teeming bazaars, colonial-style buildings, Art Deco structures and a superb choice of restaurants, often being rated as the dining capital of India. The tourist district of Colaba in Mumbai is a great place to start exploring this great city.
• Hyderabad – Hyderabad city is a great place to visit in the state of Andhra Pradesh. The place has witnessed a continuous growth for last many years. Hyderabad has become a tourist hotspot following ever increasing number of tourists during past few years. Hyderabad has a well-founded reputation as one of the safest cities in the world.
• Goa - The country's smallest state and famed for its colonial Portuguese and Catholic past, most tourists visit Goa for its endless selection of sandy beaches and coastal attractions. Standing proudly next to the Arabian Sea, Goa is a particularly compact state and often feels like a large town, being easy to travel. Around Goa, tourists will soon realize that the state has much more to offer than simply stunning beaches, fishing, water scooters, windsurfing and scuba diving.
• Bangalore - Beauty lies in the eyes of beholder and if you want to see one of the most beautiful places in India then Bangalore is the word for it. Bangalore has earned sobriquets like 'Silicon Valley of India', 'Pub Capital of India', and 'City of Gardens'. Pleasant climate with colorful gardens with lakes and glittering nightlife, Bangalore has made its own attraction for travelers as one of the most charming cities in India,
• Nagpur - Nagpur is the largest city in central India, but with its friendly atmosphere and dependable transportation, you’ll instantly feel at home. The city of Nagpur has a well-built infrastructure, is a clean and affluent city which makes a good jumping-off point for a series of trips into the far eastern corner of Maharashtra..
• Kerala - Welcome to Kerala, state in India's southern tip and a state known as God's Own Country. Kerala is one of the ten 'Paradises Found' by the National Geographic Traveler, for its diverse geography and overwhelming greenery. It is a land much acclaimed for the contemporary nature of its cultural ethos, and much appreciated for the soothing, rejuvenating paradise that it is.
• Delhi - Delhi, the capital of India is situated in the northern part of the country. Apart from being the capital of India, Delhi is also the travel hub of northern India. It serves as an excellent base for visiting the colorful state of Rajasthan, and Agra, the city of the Taj Mahal, is less than three hours away. Discover the many tales behind Delhi’s ancient, bewitching existence. Feel the excitement of stepping foot on a piece of the world’s oldest land!
• Pune - Pune is the eighth largest city in the India state of Maharashtra. The city derives its name from Punya Nagari, which means 'the city of virtuous deeds.'Pune or the 'Queen of Deccan' is known for its educational, research and development institutions. This beautiful city has many exotic locales attracting innumerable tourists.
• Jaipur – Jaipur is located in India and attracts a flurry of tourists from all over the world. Sited within eastern Rajasthan, North India, the city of Jaipur is famed for its hilltop fortresses, magnificent royal palaces and historic pink-painted sandstone architecture, earning it the affectionate nickname of the 'Pink City'.
• Chennai - Chennai formerly known as Madras is the capital city of the Indian state of Tamil Nadu. It is famous for its culture and tradition. Chennai hosts a large cultural event, which includes performances by hundreds of artists. The city has a vibrant theatre scene and is an important centre for the Bharatanatyam, a classical dance form.
• Gurgaon – It is one of the four important satellite cities of the National Capital Region and is often referred to as the 'Millennium City.' Gurgaon has recently emerged as the latest hub for Medical Tourism. Apart from being IT hub and a favorite haunt for MNC offices, the city has a number of world class hospitals that not only treat Indian citizens but also people from outside.
• Chandigarh - Chandigarh is a rare epitome of modernization co-existing with nature's preservation. It is here that the trees and plants are as much a part of the construction plans as the buildings and the roads. India’s first planned city, Chandigarh is a rich, prosperous, spic and span, green city rightly called “THE CITY BEAUTIFUL”.