Thoracic surgery

This involves surgery on other areas of the thorax than the heart - for example, the lungs or the aorta. Ramsay’s Orwell Centre offers some thoracic surgery and also specialised tests such as thoracoscopy. This involves inserting a small endoscope through a hole in the chest wall to visualise what is happening and taking a biopsy, if necessary. It is particularly useful for investigating problems between the lungs and the rib cage.

Other specialist investigations on offer include bronchoscopy where an endoscope is passed down your airways to visualise the inside of the lung and take samples. and open lung biopsies, where tissue from your lung is removed for examination. General anaesthetics are usually given for both of these.

Surgeons at the Orwell Centre can also carry out surgery to remove part of all of a diseased lung, remove the lining of a lung (to prevent the lung persistently ‘collapsing’) and to remove any pus or debris from the lining of the lung.

A relatively common problem is a thoracic aortic aneurysm, where the aorta bulges outward. This can be a serious condition if the aneurysm is large or growing rapidly and, in extreme cases, the blood vessel will rupture at the weakest point, which may be fatal.

Surgery is often suggested if the aneurysm is causing symptoms such as chest pain, is large or is expanding rapidly. This involves putting a graft into the aorta which prevents the aneurysm from growing further. It can be done as either ’open chest’ surgery or using keyhole techniques.

Surgeons at the Orwell also have experience in unusual areas such as reconstructing the chest wall. Cardiothoracic surgeon Mr Samir Shah has pioneered collaboration with the regional plastic surgery unit at St Andrew’s Hospital in Chelmsford, which has allowed some complex surgery to be carried out in one operation rather than the patient having to undergo two procedures.

He recently carried out a 10 hour operation, alongside a plastic surgeon, on a woman who had developed a serious abscess after having radiotherapy following a mastectomy for breast cancer. This condition - osteoradionecrosis - is rare but is associated with older styles of radiotherapy. Many women are thought to put up with this unpleasant side-effect of life-saving treatment but procedures such as this one can offer an enormous improvement in their quality of life.

During the operation the affected area of the woman’s chest wall was removed, and the rib cage reconstructed with titanium bars. Her breast was then rebuilt using a flap of skin from her stomach.

Mr Shah regularly works with colleagues from other specialties - including general, endocrine, ENT and vascular surgery - to ensure the best outcomes for his patients. He is he lead cancer clinician for he hospital trust and also sits on the local cancer network board.