Advancements in Minimally Invasive Procedures for Thoracic Surgery

Minimally invasive procedures account for 90 to 95 percent of the surgeries at Weill Cornell Medicine’s Division of Thoracic Surgery. It’s one of the highest rates in the city and nation.

And that puts traditional thoracotomies—with large incisions, breaking and spreading ribs, pain, and long hospital stays and recoveries—largely in the rear view.

“Now we can do minimally invasive procedures in many different ways,” explains Jeffrey L. Port, MD, attending thoracic surgeon at Weill Cornell Medical Center. “We can use a video cameras at the bedside, or a robotic platform. Either allows for smaller incisions without compromise to the operation.”

Nasser Altorki, MD, Chief of the Division of Thoracic Surgery at New York Presbyterian-Weill Cornell Medical Center and professor of cardiothoracic surgery says the adoption of this approach has led to dramatically improved patient outcomes.

“It has translated into shorter hospital stays—maybe three nights, at most,” Dr. Altorki says, as opposed to ten. “When patients come back after their surgeries two weeks later, about 80 percent or more have completely recovered from all pain. The amazing thing is that we are doing the operations with a smaller incision without compromising the quality of the interior work.”

That’s also meant less reliance on the use of narcotics and anti-inflammatories, and treating higher-risk patients who might be older or more ill—not typically strong candidates for traditional surgery.

“We’re now also operating on older patients, many over 80 years old,” Dr. Port explains. “These patients may have been undertreated in the past, and we’re getting those patients in for surgery and back to independent living. At an institution like Weill Cornell, you can push the envelope and operate on patients who are more ill. Most importantly these patients are often discharged to home without compromise to their quality of life

Weill Cornell Medicine’s multidisciplinary approach to patient care also has driven strong patient results.

“It’s not only about good surgery,” Dr. Port adds. “Our excellent ancillary services allow us to support patients undergoing the most complex operations. They’re discussed at a weekly conference, and our shared medical decision making and efficient appointments and assessments really put us at a level that’s unparalleled.”

The division also has been identifying, classifying, and genetically assessing tumors to improve treatment, and looking for markers in the bloodstream to find out which cancers are present--and whether they might recur.

“It may be that we will have some genetic information that will inform us about targeted therapies,” Dr. Altorki adds. “I see surgery occupying a larger space for how we manage those patients.”