Message from the Director
Joseph Shrager, MD
Professor
and Division Chief
The Division of Thoracic Surgery at Stanford is recognized nationally for providing the highest possible level of care for thoracic surgical problems such as lung cancer, mediastinal tumors (those that form in the area that separates the lungs), and esophageal disease. The division is composed of four highly experienced surgeons whose mission is first and foremost to provide outstanding and compassionate care to patients, secondly to conduct important basic and clinical research with the goal of developing innovative therapies, and finally to train future leaders in the field.
Stanford’s thoracic surgeons are superspecialized in “non-cardiac thoracic surgery.” That is, we are not heart surgeons or general surgeons 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 about, and lecture about around the world.
We commonly perform cutting-edge techniques such as:
- minimally-invasive, video-assisted thoracoscopic (VATS) lobectomy, where three small incisions are made in the chest, and a small video camera (a thoracoscope) is inserted through one incision while thin surgical instruments are inserted through the other incisions. The thoracoscope transmits images of the inside of the chest to a video monitor, allowing the surgeon to complete the procedure without spreading the ribs.
- transcervical thymectomy, where the thymus (a gland located behind the breast bone) is removed by means of a small incision in the neck
- anterior approaches to Pancoast tumors (tumors of the apex of the chest) that require far less cutting of muscle than traditional incisions, as well as a better chance of complete tumor removal
- lung volume reduction surgery for severe emphysema, either by a thoracoscopic (VATS) or open approach
Such minimally-invasive procedures allow for faster patient recovery times and less pain and risk than traditional methods. You and your loved one can therefore be assured that if you come to Stanford with a thoracic surgical problem, the absolute highest degree of expertise available will be brought to bear.
Although thoracic surgeons manage both benign (less harmful) and malignant (cancerous) diseases of the chest, our association with the Stanford Cancer Center (a National Cancer Institute-designated cancer center) provides our thoracic cancer patients with an added level of reassurance. Patients with problems that require a multidisciplinary approach are evaluated and/or discussed in weekly 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.
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. We hope that you will consider coming to Stanford should you need to undergo thoracic surgery. I know that you will be treated with the greatest skill and compassion available.
Joseph Shrager, MD
Professor and Division Chief
