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Clinical Services at Rush Thoracic Surgery
Programs and Services

Surgery for lung cancer
Airway/tracheal program
Hypohidrosis surgery service
Minimally invasive program
Esophageal procedures
Thoracic outlet syndrome program
Lung volume reduction surgery for emphysema
Robotic surgery for the removal of benign and malignant
Thymic and mediastinal tumors

Surgical repair of chest wall deformity
Surgery for esophageal cancers

Surgery for lung cancer

We consider excellence in surgery for lung cancer to be at the core of the mission of the thoracic surgery service at Rush. You will be treated by thoracic surgeons who specialize in the management of lung cancer and have trained to treat this disease at some of the top thoracic surgery units in the United States. We work together with oncologists, radiation oncologists, pathologists and radiologists to provide a comprehensive approach to therapy. Our surgical lung cancer specialists are specially trained to perform all of the different types of lung cancer resections that might be required — with the lowest risk and greatest chance of cure. Several studies have now demonstrated that risks are lower and cure rates higher when lung cancer procedures are performed by surgeons who are specialized in these techniques.

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Airway/tracheal program

The airway/tracheal program at University Thoracic Surgeons treats a wide range of airway and tracheal conditions.

A leader in treating tracheal disorders, our program attracts patients from around the world. Patients may be referred to us by physicians treating an underlying condition that has created the airway/tracheal issue, such as cancer or an airway obstruction caused by benign disease. We offer surgical options for patients with airway obstructions caused by benign disease or as a side effect of treatment for cancer.

New patients undergo a comprehensive evaluation, including a detailed medical history and physical examination. We carefully review the recommended course of treatment with each patient. If the patient elects to undergo the procedure, we explain each step, using diagrams and illustrations. In the operating room, while the patient is under general anesthesia, we examine the airway (trachea and bronchi) using a bronchoscope, a thin, tubelike imaging instrument.

After surgery, the surgeon reviews the timeline for recovery and course of medication with the patient and family. If the surgery is conducted because of an underlying condition (e.g., cancer), we confer with the patient's physician to establish an ongoing plan of care.

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Hyperhidrosis surgery service

Hyperhidrosis is a condition causing excessive sweating in the hands, armpits or feet of the affected individuals, and is controlled by the sympathetic nervous system. Medical therapies to treat this condition include salves, electrical stimulation and medications, and surgery is reserved for cases resistant to medical interventions.

University Thoracic Surgeons offers a well-recognized procedure to correct hyperhidrosis called thoracoscopic sympathectomy, also known as endoscopic thoracic sympathectomy (ETS). This is a minimally invasive surgical procedure in which one or more levels of the thoracic sympathetic chain ganglion are surgically destroyed. These ganglia are bundles of nerve cells that link together to form a long, longitudinal chain in the chest cavity, with a nerve branch then coming off each of these ganglions and traveling to blood vessels and sweat glands throughout the body. Interruption of this passage blocks sweating in that area of body supplied by a particular ganglion.

During the surgery, the lung on the side being operated on is deflated, and the surgeon makes two very small incisions under the armpit to access the sympathetic chain, and uses instruments such as electrocautery and surgical clips to destroy it using thoracoscopy. Thoracoscopy is a minimally invasive technique that involves making tiny incisions in the side of the chest rather than the standard larger chest incisions, and using long instruments and a small camera inserted through the small incisions to perform the surgery. The surgeon may then opt to place a very small drainage tube to drain any air or fluid that develops in the chest cavity after surgery, which is then removed prior to being discharged from the hospital within about 12 to 24 hours.

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Minimally invasive program

Rush University Medical Center's Department of Thoracic Surgery employs minimally invasive surgical techniques to treat a wide range of conditions. Using high-definition imaging technology and precision instruments, surgeons work through tiny incisions to perform these procedures. In comparison with traditional (i.e., open) surgery, minimally invasive surgery generally involves:

  • Less blood loss, postoperative pain and scarring
  • An earlier discharge, as many procedures are done on an outpatient basis
  • A quicker recovery and return to normal activities

As one of the world's foremost academic medical centers, Rush is committed to developing new minimally invasive surgical techniques and integrating them into our care. As a large referral service, we conduct thousands of these operations every year for a wide variety of conditions.

Video-assisted thoracoscopy (VATS) lobectomy for lung cancer resection. Removal of a section or lobe of the lung involved with cancer is the gold standard for localized lung cancers and offers the best chance for a long term remission and cure. This minimally invasive technique has the advantage of shorter hospital stay, less pain and a quicker return to normal activities (usually half the time as traditional open procedures). Nonetheless, only 15 percent of lobotomies in the country are performed this way.

Endobronchial ultrasound (EBUS), in which a fine-needle biopsy of mediastinal nodes or a lung mass is performed for the minimally invasive staging of lung cancer. This procedure avoids incisions altogether while still providing the pathologist and care team the much needed staging information or diagnosis.

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Esophageal procedures

We perform:

  • Stenting, in treating strictures and cancer of the esophagus 
  • Laparoscopic procedures in the treatment of paraesophageal hernias and achalasia
  • Laparoscopic procedures in the treatment of gastroesophageal reflux disease, including reoperative procedures
  • Minimally invasive esophagectomies for esophageal cancer
  • Transoral approaches to Zenker's diverticulum: transoral surgery with no incisions

Thoracic surgeons are supported by a team of anesthesiologists who are dedicated to the care of thoracic patients. After surgery, patients are followed closely to ensure the best long-term care.

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Thoracic outlet syndrome program

A single test can rarely confirm a thoracic outlet syndrome (TOS) diagnosis. Rush's thoracic surgeons design examination programs tailored to individual patients. Our TOS diagnoses are established by ruling out other disorders and then testing to see if the condition involves the nerves (neurogenic TOS) or the blood vessels (vascular TOS).

Our rigorous clinical assessment begins with a detailed history and physical examination. Additional examinations are tailored to individual patients' needs and may include:

  • Magnetic resonance (MR) angiography, magnetic resonance imaging (MRI) and computed tomography (CT) to develop images of the thoracic outlet and cervical spine 
  • Ultrasound-guided injections into the muscles involved in narrowing the thoracic outlet, which surround the brachial plexus 
  • Noninvasive vascular studies 
  • Nerve-conduction studies, or electromyography

Multiple specialists bring a broad range of expertise to the patient's care. In almost all cases, our initial treatment includes a physical therapy program tailored to the individual patient, with exercises specific to TOS.

For patients who do require surgery, the procedure may involve removal of the first rib and division or removal of the anterior scalene muscle in the neck. Patients with vascular TOS may require repair of veins and arteries.

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Lung volume reduction surgery for emphysema

Lung volume reduction surgery (LVRS) is a procedure where surgeons remove portions of diseased lung tissue damaged by severe emphysema. By removing poorly functioning tissue, remaining lung tissue can work more efficiently. Our thoracic surgeons perform LVRS using video-assisted, minimally invasive, thoracoscopic techniques that do not require large incisions.

VRS is an option for some people with severe emphysema, a chronic lung condition in which the alveoli — or air sacs — of the lungs are damaged and trap air. People with emphysema experience breathlessness, coughing, fatigue and other problems because their lungs do not function properly. There are many potential benefits of LVRS which include:

  • Greater ability for the lungs to inflate and deflate properly, which improves breathing
  • A reduced need to rely on portable oxygen tanks for many patients
  • Room for the diaphragm and the chest wall to return closer to their normal positions, which also improves breathing ability. The diaphragm (the breathing muscle) and the chest wall are abnormally positioned due to severe emphysema.
  • A great improvement in overall quality of life reported by most patients selected for LVRS. Better breathing means less fatigue and more energy to enjoy life.

Some alternative treatments to LVRS include the following:

  • Oral medications
  • Antibiotics to treat infections
  • Bronchodilators and other inhaled medications
  • Exercise, including breathing exercises to strengthen the muscles used in breathing as part of a pulmonary rehabilitation program
  • Oxygen supplementation from portable containers
  • Endoscopic lung volume reduction (experimental at present)
  • Lung transplantation

Patients who currently smoke are strongly encouraged to quit and will not be considered for surgical treatment. Smoking is the leading cause of emphysema.

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Robotic surgery for the removal of benign and malignant thymic and mediastinal tumors

  • Thymoma: Thymomas are the most common type of tumor found in the front of the mediastinum. We recommend the surgical removal of both benign and malignant thymomas.
  • Myasthenia gravis (MG): This rare autoimmune neuromuscular disorder causes muscle weakness and is always diagnosed and medically stabilized by a neurologist. It is often associated with a thymoma, in which case the thymus and thymoma are always removed. Most patients with MG alone are referred by their neurologist for a thymectomy to increase the chance of obtaining a remission of their MG.
  • Thymic hyperplasia: This benign condition — in which the thymus is enlarged for unknown reasons — usually does not require surgery. Instead, we follow the patient with CT scans over time to confirm the condition is indeed benign.
  • Thymic carcinoma: If this rare thymic tumor is localized, we typically treat it with chemotherapy or chemoradiotherapy, then surgery. If it is widespread, we treat it with chemotherapy. Our program also treats extremely rare conditions involving thymic cysts, thymolipoma and thymic carcinoids.

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Surgical repair of chest wall deformity, pectus excavatum, pectus carinatum

Pectus excavatum (PE) is an abnormal development of the rib cage where the breastbone (sternum) caves in, resulting in a sunken chest wall deformity. Sometimes referred to as "funnel chest," pectus excavatum is a deformity often present at birth (congenital) that can be mild or severe. Since most patients with the deformity do not have symptoms, treatment may not be needed, or will be dependent upon the development of symptoms. Physical therapy in young patients (under the age of 18, due to most pectus deformities remaining the same after this age) may play a role in slowing the development of the chest wall deformity and may possibly reverse some of the chest wall deformity. If pectus excavatum is compromising either the heart or lungs, your doctor may recommend surgery. Surgery: The primary goal of pectus excavatum repair surgery is to correct the chest deformity to improve a patient's breathing, posture and cardiac function. This is typically accomplished by removing a portion of the deformed cartilage and repositioning the breastbone. A variety of surgical procedures are available to repair pectus excavatum, including:

  • Highly modified Ravitch technique: Originally completed by a long incision across the chest to resect excess cartilage, reposition rib bones, and implant a wedge bone graft to correct pectus excavatum, the Ravitch technique has been recently modified as a less-invasive procedure.
  • The Nuss procedure: Thoracic surgeons use a video-assisted thoracoscopic surgery (VATS) technique, usually restricted to adolescent patients, to correct pectus excavatum.

Often called "pigeon breast," pectus carinatum (PC) is caused when the sternum (breastbone) is pushed outward. The forward protrusion of the sternum often causes pain during exercise or during times of increased respiratory effort. This abnormality is seen predominantly (75 percent) in boys, and develops somewhat later in them than it does in girls. It increases in severity with age and generally worsens during growth spurts that occur during late childhood and adolescence. Although pectus carinatum occasionally interferes with overall health, it generally does not interfere with cardiorespiratory (heart and lung) functioning.

  • External bracing technique — In children up to age 18 who have mild to moderate pectus carinatum and are highly motivated to avoid surgery, the use of a custom-fitted chest-wall brace pushing directly on the sternum produces excellent outcomes. Willingness to wear the brace as required is essential for the success of this treatment approach.
  • Surgery — In children who are not candidates for bracing, surgery may be necessary to restore normal chest contour. The length of hospital stay following surgery is typically three to four days, but children often experience some discomfort for several weeks. For several days following surgery pain can be well controlled by epidural analgesia catheters or intravenous narcotics. Milder pain is managed with oral medication. Although minor complications sometimes occur, these are quite easy to treat. Cosmetic and physical outcomes in children who have undergone surgery in mid-childhood or early adolescence are generally excellent.

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Surgery for esophageal cancers

Esophageal cancer presents in two main forms: squamous cell carcinoma and esophageal adenocarcinoma.

All patients will meet with a surgeon before treatment. Patients with early esophageal cancer first undergo surgical resection, while patients with locally advanced cancers may first receive chemotherapy, with or without radiation. We choose the most appropriate surgical approach for esophageal cancer based on the disease and the patient's needs. Generally, these procedures involve removing all or part of the esophagus and some of the surrounding tissue:

  • Standard esophagectomy: a time-tested open procedure with incisions made in the chest and abdomen
  • Minimally invasive esophagectomy: a cutting-edge procedure with multiple small incisions made in the chest and the abdomen

For patients whose clinical conditions make them unsuitable to receive surgical treatement and thus require palliative treatment, we may offer photodynamic therapy (using lasers to remove blockages of the esophagus) or stents (if blockages exist and cannot be managed with laser techniques) to improve swallowing.

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Contact Phone
(312) 738-3732
Contact E-mail
contact_rush@rush.edu



LocationHours of Operation
Rush Professional Office Building
1725 W. Harrison St., Suite 774
Chicago, IL 60612

Call (312) 738-3732 for inquiries about office hours or to arrange an appointment.



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