Thoracic Surgery and Thoracic Surgical Oncology

The Department of Thoracic Surgery and Thoracic Surgical Oncology, Fortis  Escorts Hospital

The Department of Thoracic Surgery and Thoracic Surgical Oncology was the first such clinical department in India solely dedicated to the care of patients with non-cardiac thoracic diseases.With the establishment of this department, Fortis Healthcare made a substantial commitment to growth in all areas of clinical thoracic surgery.

This commitment is evidenced in the breadth of diagnostic and treatment services available for patients with benign and malignant tumours and other disorders of the lung, esophagus, mediastinum and chest wall.

This department is now well known for its surgical expertise and is capable of treating all surgical disorders within the domain of surgical chest disorders with results matching international standards. It is also a very prominent centre for thoracoscopic surgery (VATS) in North India.

About The Faculty

All surgeons are full time surgical services at Escorts

• Dr Sabyasachi Bal, Director
• Dr Rakesh Kumar, Consultant
• Dr LM Darlong, Consultant
• Binant Kaur / Jatin Arora  Physiotherapists

All  patients have access to a team of experts from many different fields including specialists from surgery, pulmonary medicine, critical care and ultramodern radiology.

Dr S Bal is the Director of the department of Thoracic Surgery and Thoracic Surgical Oncology and is assisted by Dr Rakesh Kumar and Dr LM Darlong, both consultants with considerable surgical experience and expertise and a team of dedicated surgical intensivists and pulmonologists, anaesthesiologists, paramedical personnel and physiotherapists.

Dr Bal, is an alumnus of AIIMS, New Delhi and was, till 2005, an Additional Professor of Surgery and Consultant Thoracic Surgery and Chief of the Lung Cancer and other thoracic malignancies Clinic at his alma mater, the prestigious All India Institute of Medical Sciences, New Delhi.

He is a former fellow of the internationally renowned Memorial Sloan Kettering Cancer Centre at New York and a Senior Registrar at the Royal Marsden Cancer Hospital, London.

He has trained in Thoracic surgery in AIIMS, New Delhi and in the UK at the South West Regional Thoracic Surgery Unit at Bristol and at the Brompton Chest Hospital, London. He has been a clinical research fellow at University of Leicester, UK in Lung Volume Reduction Surgery for Emphysema; which he has pioneered in India.

Dr Bal is also one of the pioneers in diagnostic and therapeutic thoracoscopic procedures and today, the department gets referrals from all over North, East and North-East India. He is a member of many surgical societies in India, USA, UK and Japan and has numerous peer reviewed scientific publications and awards to his credit including the Norman Tanner Best Paper Award (Royal Society of Medicine, UK), the Japanese Surgical Society Award in 1996 & 1997, the Varoon Mahajan Fellowship of the Memorial Sloan Kettering Cancer Centre, New York, USA, the Escorts Raj Nanda Pulmonary Fellowship to Glenfield Hospital, University of Leicester, UK and the Best Paper Award of the Indian Association of Surgical Oncology in 2002.

Services available:

The department provides the following services

• Major resections for lung and esophageal carcinoma and other tumours including chest wall and sleeve resections
• Resection of pulmonary metastasis
• Oesophageal resections
• Surgery for malignant mesothelioma
• General Thoracic Surgery for benign lung disorders like bronchiectasis, hemoptysis, aspergillomas, Multl-drug Resistant TB, pleural Diseases and various mediastinal pathologies
• Surgery for benign oesophageal disorders
• Pleural diseases such as empyema and pneumothorax
• Tracheal resections for strictures, tumours and trauma
• Complex Resections for Thyroid Cancer
• Lung Volume Reduction Surgery for emphysema
• Surgery for Mediastinal tumours
• Video-assisted diagnostic and therapeutic surgery (including oesophageal motility disorders and thymectomy for myasthenia gravis).
• Thoracoscopic sympathectomy for hyperhydrosis
• Malignant Pleural and Pericardial effusions-Thoracoscopic treatment
• Chest wall deformities
• Soft tissue and Solid Tumours including chest wall primary lesions

Areas of special interest

Lung Cancer, Oesophageal cancer and Thoracic tumours

Lung Cancer is emerging as one of the most important cancer problems in India. In recognition of the need for a dedicated service for treating these cancers, the department has an active thoracic cancer programme. Dr. Bal was the founder of the Lung Cancer Clinic at AIIMS and has had extensive experience m the surgical treatment of lung and other thoracic cancers.

The department is especially known for its extensive work related to thoracic cancers. It has the largest experience in the treatment of lung and other thoracic cancers in North India and its results are comparable to current international norms and has one of the largest experience in the treatment of mesotheliomas, thyroid and parathyroid tumours.

The Department offers innovative or minimally invasive surgical treatments (videothoracoscopy, brachytherapy and laser bronchoscopy) as well as traditional surgical procedures in the treatment of malignancies.

All  cancer patients require a multidisciplinary approach

They are evaluated and/or discussed in combined conferences that include radiologists, oncologists, radiation oncologists, and others who are superspecialized in thoracic tumors. This type of coordination of care helps reduces the stress and confusion that can be associated with a new cancer diagnosis.
Video-Assited Thoracic Surgery

Video-Assisted Thoracic Surgery or VATS enables surgery to be performed within the chest with minimal injury to surrounding structures. Thoracoscopic operations require much smaller incisions than those used for an open procedure.The resultant benefits for patients are less discomfort and less time in the hospital. At Fortis Hospitals network, VATS for pulmonary neoplasms and metastasis, pleural diseases, emphysema, chest injuries as well as thoracic sympathectomy and esophageal disorders and mediastinal tumour and thymectomy for myasthenia gravis and thymic tumours is routinely performed.

Dr Bal is one of the pioneers in diagnostic and therapeutic thoracoscopic procedures and today, the department gets referrals from all over North, East and North-East India.

Lung Volume reduction surgery for smoking related emphysema

LVRS is a new treatment for smoking related emphysema and involves removing about 20 to 30 per cent of the damaged lungs so that the remaining tissue and surrounding muscles are able to work more efficiently, making breathing easier and increasing exercise capacity. The surgery has been shown to improve patients' quality of life significantly. as they experience less shortness of breath and become less dependent on oxygen therapy. The department is the only unit in North India with expertise in LVRs and attracts patients from UK, USA and other foreign countries for this procedure.

Expert surgical critical care

Good results stem from sound postoperative and vigilant critical care. Our Critical Care Unit is equipped with state-ofthe-art digital monitoring systems together with ventilatory support and automated drug delivery systems. There are dedicated facilities for managing postoperative thoracic surgical cases. The department is headed by Dr Pinak Srikhande, a renowned intensivist. and critical care expert.and is supported by a highly trained team of doctors. We maintain a one to one nurse-to-bed ratio in our ICUs, ensuring personalised attention.

Why should you come to us for care ?

Fortis' thoracic surgeons are superspecialized in “non-cardiac thoracic surgery.” This means that we are not heart surgeons, general surgeons or “surgical oncologists” who perform only the occasional lung cancer case.

Surgery for diseases of the lungs, chest wall, esophagus, and mediastinum is our primary focus and our reason for existence.
These are the diseases we operate upon day in and day out, the diseases we think about, write and teach about.

In recent years, a close link has been identified between volume and quality in complex surgery. Surgeons who perform more of these operations and are specialized in certain diseases without doubt achieve better outcomes. Large centers like ours, therefore, clearly provide advantages for patients with thoracic surgical diseases.