This technique is used for taking tissue sample from lymph nodes or mediastinal tumors for further investigation.

VATS-video assisted thoracic surgery. This technique is done under video controll, provides more tissue for examination. Lobe resection can also be done this way, with three small incisions.

Thoracotomy- it is an incision for open thoracic surgical procedures.

Sternotomy- this incision is done with dividing the sternum. After the operation the pain is less than in case of thoracotomy.

PTX occurs when air gets between the layers of the pleura, the ventillation of the involved lung segment is adversely affected. Depending on the type of PTX, the treatment could be observation, needle aspiration of the air, drainage or in severe cases VATS.

Can be caused by several reasons. VATS can be used for diagnostic reasons in idiopathic cases, tissue sample can also be taken. In case of infective background ( empyema thoracic), drainage is done first.

In these cases there is an overproduction of sweat. It can occur in the hands, axilla or/and face. The problem can be solved surgically by clipping the sympathic nerve chain.

In case of young adults pectus excavatum can be solved with VATS technique, Nuss procedure.

Depending on the histological type, different surgical procedures can be used. In case of malignancy, chemo and radiotherapy is also required together with surgery.

There is a great number of diseases in this group. Most frequently pathological lymph nodes are found, caused by sarcoidosis, lymphoma, metastasis of lung cancer. VATS, thoracotomy or sternotomy is done, depending on the localization of the tumour.Diseases of the thymus ( myasthenia gravis, tumours) are operated with sternotomy or VATS.

Most of the operations are done because of lung cancer. Depending on the size and localization of the tumour, one lobe (lobectomy), two lobes (bilobectomy) or the whole lung (pneumonectomy) has to be taken out. It is very important to know the stage of the tumour, whether lymph nodes or other organs are involved in the disease. The physical status of the patient is also very important, whether the operation can be done at all. The team work of thoracic surgeons and oncologists is essential. Smoking plays an outstanding role in lung cancers and it can be also responsible for pneumonia after the operation.
I have started operating lung cancer with VATS, which is a new way. With this technique there is less pain, the incision is smaller, the heeling of the patients is faster than with thoracotomy.

Sometimes it is difficult to tell whether the focal lesion in the lung is benign or not. It can cause differential diagnostic problems. With VATS the lesion can be removed and than the lesion can be histologically examined. If it turnes out to be malignant the appropriate type of surgery can be perfprmed.

Tumours, relaxation and injury of the diaphragm occur rarely. These can be solved sugically.

Tumours of the trachea are rare, usually diagnosed in a late stage. Stricture of the trachea usually appears after long-time artefical respiration.

The most common respiratory disease nowadays is the Chronic Obstructive Pulmonary Disease (COPD), in which smoking plays an important role. After a time emphysema of the lungs may occur, it is hard for the patient to breathe and later it can be worse despite of steroid and oxygen therapy. Volume reduction technique, done via sterotomy, offers help for these patients. The ill, malfunctioning part of the lung is removed.The patients are selected under strict conditions (smoking free for 4-6 months before the operation is required).
The other solution is lung transplation, which is not done in Hungary, the closest place is Vienna, Austria.

Laparoscopic technique is used in case of reflux, hernia or achalasia. Consultation with gastroenterologist is required. Diverticuli (a sack coming from the wall of the esophagus) can cause great variety of symptoms or none at all.They can be removed surgically.
Most of the benign lesions of the esophagus can be solved with VATS.
Malignant tumours are usually discovered too late, in a stage when surgery can not be done. Sometimes radio- and chemoterapy can bring the patient to an operable stage.In early stage,of esophageal tumour, the esophagus is removed subtotally. The neighbouring lymph nodes are also taken out. For the ability to swallo, part of the stomach or large intestine is used. These operations are long, tough for the patients as well, and even if no complications occur, 10-14 days of stay in hospital is necessary.

Hernias occur when the wall of the abdomen is not strong enough to deal with the intraabdominal pressure. These problems can also be solved surgically.

Gallbladder stones can often cause problems. To avoid severe complications the gallbladder is removed together with the stones surgically. This is called laparoscopic cholecystectomy (LC). 2-3 days of hospital stay is necessary in complication free cases.