Collapsed lung | Thoracic Surgery University Hospitals Birmingham

When air leaks out of the lung it collapses and leaves a space around it. The medical term for a collapsed lung is a pneumothorax. A small pneumothorax will often heal by itself, however sometimes they don’t heal up or they come back. A chest drain may be used at first but if this fails an operation may be needed to help re-inflate the lung and stop it collapsing again. If you have had a pneumothorax more than once, surgery is intended to help prevent this happening again.

Thoracic surgeons look after patients who need surgery for a pneumothorax. They also look after patients who have a pneumothorax that is difficult to treat, even if they do not need surgery.

What causes a pneumothorax?

• Trauma – including some medical procedures. Surgery is rarely required in this instance and the risk of it happening again without trauma are low.
• Lung diseases
• Smoking
• Young tall men are more at risk
• Young women may get a pneumothorax in relation to their menstrual cycle (catamenial pneumothorax)

What does the operation involve?

A number of techniques can be used to fix a pneumothorax. There are two parts to the surgery; dealing with area of lung that has leaked and preventing the pneumothorax from coming back. These procedures are done as keyhole (VATS) surgery. VATS stands for Video Assisted Thoracoscopic Surgery.

During surgery you lie on your side with your arm raised. Up to 4 small cuts are made, each about 5cm (2 in) long. These are used for the instruments and small camera to go into the chest. Special staples are used to cut and seal any parts of lung that need to be removed. The piece of lung can be removed through one of the small cuts. The wound is closed with dissolvable stitches. 1 or 2 chest drains are put in at the end of the operation and held in placed with a stitch. These remove any fluid or air from around the lung.

If a part of the operation cannot be done keyhole the operation may need to be changed to the open technique (thoracotomy). Open surgery is done with one longer cut under the shoulder blade between 2 ribs. The 2 ribs are parted to get into the chest. One rib may be cut to give more space, ribs are not removed. At the end of surgery the 2 ribs are held back together with strong stitches. The muscles and skin are also stitched back together.

If you have had repeated episodes of pneumothorax or you wish to do scuba diving your surgeon may decide it is best to use the open technique to do your operation.

• Dealing with area of lung that has leaked

Bubbles of thin lung tissue around the edge of the lung can be the cause of a pneumothorax if they burst. A small bubble is called a bleb, a large bubble is called a bulla. Removing these abnormal parts of the lung helps stop air leaking out of the lung. Removing such a small amount of lung does not give you any long term breathing problems.

• Preventing the pneumothorax from recurring

If the lung becomes stuck to the inside of the chest wall there is less chance of the lung collapsing. Removing the pleura on the inside of the ribs makes the inside of the chest wall sticky. This causes the lung to stick to chest wall. Alternatively sterile talc powder can be put into the chest usually during the operation. The powder causes irritation which makes the lung stick to the chest wall. The lung sticking to the chest wall is called pleurodesis.

What is recovery like?

Recovery in hospital and recovery at home apply to surgery for pneumothorax.

Women affected by catamenial pneumothorax may benefit from hormonal treatment to stop ovulation. This is usually directed by a gynaecologist.

Particular care should be taken if you are considering flying or scuba diving.

• Flying

You must have had a chest X ray which shows the pneumothorax has completely gone. You must then wait at least 1 week after the chest X ray showing your pneumothorax has completely gone before flying. If you had a pneumothorax because of trauma, you must wait at least 2 weeks after the chest X ray showing your pneumothorax has completely gone before flying. Guidelines may change, you should check with your doctor before flying.

• Scuba diving

Diving without treatment for a pneumothorax is extremely dangerous. Diving causes big changes in the respiratory system and compression of air within the body. If your pneumothorax happened for no reason you should not dive unless you have had surgery on both sides of the chest to prevent a further pneumothorax. After surgery you will need to have normal lung function tests and a normal CT scan of the chest before diving. Guidelines may change. You should have a specialist assessment of your individual fitness for diving prior to doing so. Ask your diving organisation for contact details, some GPs may be able to do assessments but many of them will not have had the training to do so.

See also:
Pain control
Exercise and physiotherapy

What are the risks?

General risks of thoracic surgery apply to surgery for pneumothorax.

In addition the following risks apply:

• Recurrence

If you had no specific cause of the pneumothorax, the risk of it coming back without surgery is 20 to 30 in 60. If the pneumothorax was caused by lung disease the risk of it coming back is 24 in 60. If you have VATS surgery pneumothorax, the risk of it coming back is 3 in 60 people.

Recurrence usually happens within a few years of the first pneumothorax but it can happen many years later. It may come back on the other side of the chest.

• Prolonged air leak

Air may continue to leak out of the lung after surgery. Occasionally this lasts for longer, possibly weeks. A chest drain will need to be in place until this settles, you may be able to go home with the chest drain still in and come back for regular check-ups until the air leak settles. The risk of this is higher if lung disease caused the pneumothorax.

What are the alternatives to surgery?

It is your choice whether to go ahead with surgery or choose another kind of treatment. We will respect your wishes and support you in choosing the treatment that suits your individual circumstances. You are always welcome to seek a second opinion.

If you do not want an operation other options may include:

• Continued use of chest drains.

Given enough time the lung should heal and stop leaking air, this may take weeks. If you have a lung disease and surgery would be too risky your surgeon may advise you it is safest to wait for the lung to heal. Different types of drains and drain settings may be used to try and help this process.

• Talc pleurodesis

We can help the lung stick to the chest wall without an operation in some cases. Sterile talc powder is mixed with sterile water and flushed up the chest drain. A small amount of your own blood may also be used instead of the talc and water mixture. This requires a chest drain but does not require you to be asleep under a general anaesthetic. Putting the talc powder in during an operation has a higher success rate than via a drain (95% for surgery vs 75% using the drain).

Symptoms, Treatments, and Recovery in 2022

When you think of the potential injuries you can suffer due to a car accident, things like whiplash or a concussion may come to mind first. While these are common, there is a wide range of possible car accident injuries you may not think about. For example, a punctured lung or collapsed lung can occur as a result of a car accident and have severe consequences. Read on to learn more about this injury and what it means.

What Is a Punctured Lung?

A punctured lung, also known as a collapsed lung or a pneumothorax injury, occurs when air enters the space between the lung and the chest wall. This air presses on the outside of your lung, causing it to collapse in full or in a portion. The lung can then not expand properly, preventing oxygen from entering the bloodstream efficiently.

Depending on the cause of a punctured lung, it may be categorized in one of three ways:

Traumatic pneumothorax: A direct trauma to the chest, like a broken rib or an injury from a stab wound or gunshot, causes this type of pneumothorax. There are also medical procedures that deliberately collapse the lung in a controlled environment, which would also be considered this form of the condition.

Primary spontaneous pneumothorax: This occurs when the punctured lung happens without an exact known cause. It commonly is a result of a rupture in a small air sac on the outside of the lung, which allows air to leak into the surrounding cavity.

Secondary spontaneous pneumothorax: When a punctured lung is caused by a pre-existing lung disease, it is classified this way. Common conditions that induce a collapse may include cancer, asthma, or chronic obstructive pulmonary disease (COPD).

Causes of Punctured Lungs

While it is not always clear what caused a punctured lung, there are a number of known causes.
A chest injury can cause a lung to collapse, including a car accident. The impact itself of blunt force to the chest can be a factor, or a broken rib may puncture the lung. Other physical assaults, use of weapons, and sports injuries can have similar outcomes. It is also possible for a medical procedure to purposefully or accidentally cause a puncture, such as during the insertion of a needle into the chest.

Damaged lungs are more likely to collapse. Underlying diseases like pneumonia or cystic fibrosis are, therefore, potential causes. Cystic lung diseases, like Birt-Hogg-Dube syndrome, can cause round, thin-walled air sacs in the lung tissue to rupture and cause pneumothorax. People who need mechanical assistance to breathe can also experience an imbalance of air pressure within the chest that causes the lungs to collapse completely.

Ruptured air blisters can also be a cause when small air blisters known as blebs develop on the top of the lungs. When they burst, air leaks into the space surrounding the lungs and causes a collapse.

In general, men are more likely to suffer a pneumothorax than women. People between 20 and 40 are the most likely to have an incident caused by ruptured air blisters, especially when they are tall or underweight. Other risk factors can include genetic predisposition, previous pneumothorax, and smoking cigarettes.

Symptoms of a Collapsed Lung

It is critical to identify a collapsed lung as soon as possible to seek early treatment and avoid the injury becoming life-threatening. If you have experienced any trauma to the chest or have existing lung conditions, look for these signs:

• Chest pain that worsens with coughing or breathing deeply
• Shortness of breath
• Abnormalities in breathing patterns
• Tightness in the chest
• A rapid heart rate
• Pale or blue skin (due to reduced oxygen)
• Fatigue

A punctured lung may cause soreness in the chest, usually on one side, as only one lung is usually affected.

If tension pneumothorax is present, you may experience signs of cardiovascular collapse and should treat this as a life-threatening emergency. In this case, large veins in the neck may stick out, the pulse may be rapid, and blood pressure may be low. Anxiety and difficulty speaking are also common. If untreated for more than several minutes, loss of consciousness, shock, and death can occur.

Diagnosis of a Punctured Lung

If it is suspected that you have suffered from a punctured lung, your doctor will first specifically listen to your chest using a stethoscope. They may tap your chest while you breathe in order to listen for hollow sounds. They may also suggest an arterial gas test to assess if you are experiencing high levels of carbon dioxide and low levels of oxygen, which can indicate a problem.

In order to get a definite diagnosis, you will need to undergo imaging like an x-ray, an ultrasound, or a CT scan. Very small cases can be missed on a routine chest x-ray, and a doctor may take multiple films, including x-rays in full expiration to ensure they identify any signs of a collapsed lung.

Treatment Options

The treatment for a punctured lung will vary based on the severity of the trauma, cause of the condition, and amount of damage to the lung. The goal is to reduce pressure on the lung and allow it to re-inflate.

In the case of a small pneumothorax, it may heal on its own under the supervision of your doctor. Oxygen and rest are often prescribed as the primary treatment in these cases, or a doctor may release additional air by sucking it out through a needle and allowing the chest to expand fully. If this isn’t performed, the excess air can be re-absorbed over time. Repeated x-rays are used to monitor the condition and ensure it has resolved.

When the pneumothorax is larger and requires intervention, a chest tube is placed through the ribs and into the area around the lungs to help drain the air. This tube may be left in place for both drainage and to help inflate the lung. Severe cases may require the tube to be left in for several days before the chest begins to expand.

To prevent a future collapse, a doctor may also perform chemical pleurodesis, in which chemicals are sent through the tube that help the lung attach to the chest cavity and eliminate extra space.

If the air is not removed by the tube or a patient suffers from repeated punctured lungs, surgery would be the next step. Large puncture wounds may also require surgery if the lung tissue cannot close immediately and repair itself. These repairs would be done by a surgeon who places a tube down the throat into the bronchial airways or makes an incision into the skin. Depending on the injury, a surgeon may also place a tube to remove excess air and suction out blood cells and fluid in the pleural space.

Recovery and Aftercare

It will usually take about 6 to 8 weeks to fully recover from a collapsed lung. However, the severity of the injury and the treatment method may make this period longer or shorter.
Some things you can do to aid recovery and prevent complications include:

• Get plenty of sleep. You may feel weak and tired for a while, and that is okay.
  Take any medication your doctor prescribes exactly as directed. Ask about over-the-counter medication before taking any.
• If you need to cough or take deep breaths, hold a pillow against your chest for added support and to decrease pain.
• If you are prescribed antibiotics, take them as directed. Do not stop if you feel better and the full course has not yet been completed.
• If you have a bandage over a tube or the area where a tube was, keep it clean and dry. Follow all instructions on care.
• When you have a tube in place at home, follow all directions and do not adjust the tube in any way. This could break the seal or cause other problems. Ensure the tube is dry at all times.
• Avoid movements that require your muscles, especially in the chest, to strain. This includes laughing hard, bearing down to have a bowel movement, and heavy lifting.
• Do not fly in an airplane unless you are given the okay by your doctor.
• Stay active with low-impact movement and incorporate rest.
• Sleep in a position that elevates your torso in the first days.
• Avoid unnecessary pressure being placed on the ribcage.
• Wear loose-fitting clothing.
• Avoid smoking and do not let others smoke around you.
• Avoid any sudden changes in air pressure.
• Avoid driving until you are fully recovered.
• Closely monitor for signs of recurrence.
• Follow your doctor’s instructions for breathing exercises.
• Attend all follow-up appointments.

If you undergo surgery, recovery may be longer and more intensive. It is common to be recommended physical therapy after surgery to help you regain strength and lung capacity, especially if you are immobilized during immediate recovery. Any activity should be done under the supervision of your doctor and a licensed physical therapist to avoid further injury.

During recovery, if you begin to experience any symptoms again or notice a fever, new and worse pain, new and worsening trouble breathing, coughing up blood, or your chest tube coming out, you should seek immediate care. If you pass out for any amount of time or have severe trouble breathing, place a call to 911.

Potential Complications and Patient Outlook

While punctured lungs are serious, they are not fatal in most cases, and treatment is usually effective. The most common complication related to a punctured lung is the increased risk of suffering another one in the future. About 35% of people who have a punctured lung will have another one at some point.

Shock is also a common complication, especially when there is a serious injury or infection, severe inflammation, or fluid accumulation in the lung. Tension pneumothorax, which can cause cardiac arrest, is also a potential issue.

A healed pneumothorax usually does not have any long-term health implications if it is treated quickly, though trauma-induced collapses increase the risk of recurrence and may require more monitoring on an ongoing basis.

Can You Prevent a Punctured Lung?

There is no known way to prevent all pneumothorax, especially in patients with a family history of the condition. When trauma is the source, it may also be unavoidable. However, there are ways to reduce the chances of suffering from a punctured lung for those who may be at risk. Avoiding smoking is highly recommended, for example.

If you engage in activities that involve a drastic change in air pressure, like flying or diving, you may speak with your doctor about how to manage this.
For those with underlying lung conditions, continue to monitor appropriately with your physician.

Punctured Lungs and Car Accidents

While it is not the most common cause of punctured lungs, they are a potential outcome of motor vehicle collisions. This can occur in a variety of ways:

• Seatbelts and airbags can cause a rib or multiple to break, and the jagged bone can puncture the lung.
• Glass fragments from a windshield or window can puncture the lung.

Because of the traumatic nature of a car accident, many people experience shock and adrenaline rushes that hide symptoms of serious injuries. You may not notice chest pain or shortness of breath immediately following your crash and not be taken to a hospital for observation, even though your lung has been punctured. This is why it is critical to seek medical care as soon as possible after your accident.

A skilled doctor like those at AICA Lithia Springs will assess the entire body for injuries, even those there are no symptoms of yet. During a physical examination, if we notice a punctured lung, we will be able to use imaging technology to determine the next steps. This early intervention may be the difference between simple intervention and requiring surgery as the condition is allowed to worsen.

If you have recently been in an accident, contact AICA Lithia Springs today to schedule a consultation and gain peace of mind.

Category: Accident Prevention, Accident Recovery

Surgical treatment of scoliosis in Moscow at the Dikul clinic: prices, appointments

Life for a person with significant scoliosis can become a real problem. It can be both painful manifestations and psychological discomfort associated with appearance. There is also a risk that the curvature will progress. Sometimes people may think that scoliosis surgery is the best (and only) option. They don’t know that there is an alternative to surgery.

Absolute indications for surgery:

In most cases, surgery, even with severe scoliosis, is an elective procedure, not a necessity. In fact, only 0.1% of scoliosis cases actually require surgery.

In most cases, the operation is recommended by the doctor, because conservative methods of treatment have not been fully used.

Before considering surgery, patients and parents of children with scoliosis should be aware of the reasons why surgery is necessary (or not required) and the possible complications that may result from spinal surgery.

There are specific situations where surgery is probably the right choice.

• Chronic debilitating pain. Patients who experience very severe pain that interferes with their daily activities may require surgery as a last resort to achieve pain control. Patients with scoliosis associated with severe spinal degeneration, spinal stenosis, or lateral listhesis may experience severe debilitating pain associated with possible nerve damage or osteoporotic fractures. In these cases, surgery may be required.
• Loss of bladder or bowel control due to nerve root or spinal cord injury. This symptomatology is an indication for emergency surgery.
• Weakness or atrophy of an arm or leg due to nerve compression injury associated with scoliosis.
• Impaired lung and heart function. In a small proportion of people, severe scoliosis in the upper back leads to chest deformity, which can affect the ability to breathe normally or impair heart function. In cases of severe dysfunction of the heart or lungs, surgery may be required.
• Postural collapse. In cases of severe severe scoliosis, posture can be dramatically disturbed. This is a very painful condition with impaired motor functions that requires extensive and invasive surgery as the only means of reducing collapse and improving posture.

If none of these five situations apply to the patient, then non-invasive therapies may be an excellent option to reduce scoliosis pain, reduce cosmetic defect, and avoid curve progression.

Conservative treatments can be effective for both idiopathic and degenerative scoliosis.

The conservative treatment of scoliosis uses specially designed exercise programs, corrective corsets, rehabilitation procedures, specific isometric exercises, and targeted stretching protocols.

Surgery for degenerative and idiopathic scoliosis:

Depending on the age of the patient and the severity of the curve, different types of surgery are recommended. The goals of each of these surgeries are to stop progression and try to reduce the angle of curvature along with improving the patient’s posture.

The most common of these are pivot and merge operations. In this method, two or more vertebrae are fused together to create a single rigid segment of the spine that is no longer able to move. Rods made of various steel alloys are attached directly to the bones of the spine to stabilize the fusion site.

Very young children with scoliosis are often recommended for surgery that involves regular replacement of the rods. In this procedure, rods are attached to the child’s spine to stabilize the curvature while they continue to grow. Using this procedure can mean 10 or more spinal surgeries in the early years of the child until the skeletal system is completed and sometimes a final fusion is performed.

There are new methods of operations using special rods MAGECTM (MAGnetic Expansion Control). These rods can be extended remotely and therefore require fewer operations.

Surgeons who choose to perform spinal fusion on girls under 10 years of age or boys under 12 years of age risk minimizing their ability for healthy lung growth and may result in an unusually short torso.

Other less invasive surgeries include Vertebral Body Bonding (VBT), Vertebral Body Bonding (VBS) and ApiFix. These three surgeries involve attaching structures to the spine to straighten the curves of the patient’s spine as they grow. Using screws or implants on only one part of the spine allows the body to use its natural ability to correct spinal deformities over time. But these minimally invasive operations are possible only in a certain group of patients with scoliosis.

Scoliosis surgery details

Patients should be aware that there are significant risks associated with scoliosis surgery. In general, the spinal fusion process is as follows:

• Patients are given anesthesia for an operation duration of 4 to 6 hours.
• Various approaches can be used to access the spine. They may include a back, front, or side approach. Sometimes a combined approach is used, some use a thoracotomy to access the spine through the chest.
• The spine is reconstructed using various metal instruments. Often the spinal joints are also removed and replaced with a bone graft. The patient may receive bone material from another part of the body – this is called an autograft, or donor materials or synthetic material may be used. These external sources do not always take root, as the body may reject these materials.
• Some patients with very large curves undergo multiple surgeries. In this case, at the first stage, the spine is released in the area of ​​curvature by cutting the muscles and ligaments, and the patient is in halo-femoral traction for several weeks. During this time, the spine can lengthen, and then during the second stage, fusion is performed.

Recovery and prognosis after surgical treatment of scoliosis

Such a complex operation requires a significant recovery period.

The time spent in the hospital in the postoperative period will vary, but most patients are on strict bed rest for 3-4 days.

During this time, a variety of tubes may be used to drain excess fluid from the chest if a thoracotomy is being performed, and catheters and fluids help support normal feeding and waste removal functions. Many patients experience pain after surgery and require an epidural, with further transition to oral analgesics. Rarely, children after surgery may be assigned a hard brace.

Patients do not understand that it takes time before they see tangible results of the operation. Although the spine may initially appear more straight, it takes at least three months before consolidation occurs and up to 2 years for complete fusion.

Non-surgical treatment of scoliosis based on specific exercises can provide significant results in as little as two weeks and does not include pain and the risk of surgery. Therefore, surgical treatment of scoliosis is a necessary measure.

Risks – both during and after surgery

Almost all surgical procedures carry some element of risk, but spinal surgery in particular can lead to complications both during and after surgery, including:

• Reactions to anesthesia or postoperative pain medications
• Bleeding, blood clots (thrombi) or infection
• Gallstones or inflammation of the pancreas
• Intestinal paresis
• Excessive blood loss requiring blood transfusion
• Nerve injury resulting in muscle weakness or paralysis
• Lung problems up to 1 week after surgery, with normalization of respiratory function within 1-2 months after surgery

Other serious complications may also develop months or even years after surgery, again calling into question the decision to operate without an absolute indication for surgery.

Long-term problems include:

• Pseudarthrosis is a painful condition in which a false joint forms at the fusion site. This happens when the operated area does not heal properly or does not heal at all.
• Back pain. Spinal fusion patients have limited mobility, which can overload the motor segments and eventually lead to disc degeneration.
• Broken or misplaced device. The metal bar or hook that holds the spine in place can move, wear out, or break. This can lead to pain and other complications.
• Compensatory curvatures. New curvature or scoliosis may develop in other areas of the spine, thus compensating for the fused vertebrae. It is more common in children who have had surgery before reaching skeletal maturity.

Unfortunately, most patients need revision surgery to correct many problems that occurred during their original procedure. Often also referred to as “salvage surgery,” revision surgery is an attempt to correct a patient’s scoliosis and move or replace instrumentation or treat an infection or deformity. Long-term complications of revision surgery can exceed 25%.

Bottom line: The decision to have surgery to treat scoliosis may lead to a second, more invasive surgery.

Treatment

• Neurology
• Physiotherapy
• Apparatus therapy
• Traumatology and Orthopedics
• Arthrology
• Podiatry
• Rheumatology
• Manual therapy
• Osteopathy
• Reflexology
• Carboxytherapy
• Therapeutic massage
• Dietetics
• Gynecology
• Pediatrics
• ENT (otorhinolaryngology)
• Urology

Lung Cancer Specialist Vienna (Austria): University Prof. Dr. Müller

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prof. University, -Prof. Dr. Michael Rolf Müller is a former president of the European Society of Thoracic Surgeons (ESTS), a world-renowned specialist in thoracic surgery and head of the pulmonology center at a private clinic in Döbling.

Thanks to the modern treatment concept at the Pulmonology Center of the Privatklinik Döbling, patients with lung cancer receive high-quality treatment with close interaction between all relevant disciplines. New minimally invasive forms of treatment and a strategic combination of conservative and surgical treatment measures are the key to success.

Modern treatment concepts in the pulmonology center of the Döbling Privatklinik in Vienna

The Döbling Privatklinik has been one of the most famous clinics in Vienna for many years. This high standard is maintained in our own pulmonology center. A well-established team around Prof. Dr. med. Dr. Michael Rolf Müller offers the most advanced methods both in the operating room and in patient care before and after surgery.

Advanced lung diagnostics

The state-of-the-art medical equipment at the Privatklinik Döbling allows reliable diagnosis of all diseases of the lungs and respiratory tract. The clinic has a whole body plethysmograph for a reasonable diagnosis of pulmonary emphysema, pulmonary fibrosis, COPD and bronchial asthma. In addition, gas exchange disorders are diagnosed and allergic symptoms are clarified.

The Clinic’s Radiological Institute offers all modern imaging techniques, as well as interventional radiological procedures (punctures, drainage). Thanks to the close cooperation of the Privatklinik Döbling with other centers, endobronchial ultrasound (EUS) can be offered for the determination of lymph nodes.

Minimally invasive lung cancer treatment

Minimally invasive chest and lung surgery (keyhole technique) has become the standard for a large number of diseases in specialized departments. The Döbling team is a leader in this field and also performs major lung surgery to treat lung cancer in a minimally invasive way. The entire procedure is performed with the highest precision through one small skin incision using a high resolution camera system.

Depending on the size and location of the tumor, a lung segment or lobe is removed along with regional lymph nodes. The surgical team of the pulmonologist Prof. Dr. Michael Rolf Müller works closely with specialized anesthesiologists. The sparing operation is supported by special anesthesia using special intubation techniques and unilateral ventilation. All patients are closely monitored and cared for during and after surgery in the recovery room.

Surgical removal of metastases in the lungs

Tumor cells can enter the lungs from various parts of the body with the blood stream and form colonies there, the so-called metastases. Metastases to the lungs are usually asymptomatic and are detected either incidentally or during follow-up examinations after a malignant disease.

In many cases, the appearance of lung metastases does not mean the end, but the beginning of a new treatment concept. In the case of isolated lung metastases, they can often be completely removed by minimally invasive methods. If this method is not suitable, an accurate analysis of the tissue by removal of the lesion can be performed to determine the optimal medical treatment. With the help of minimally invasive technology, the hospital stay can be reduced to a few days, and any planned medical treatment can be started quickly.

Treatment of functional disorders of the lungs, chest and diaphragm

Surgically significant functional disorders of the lungs include the following clinical presentations:

Pulmonary emphysema, pneumothorax

sharply hyperinflated and functionally useless areas (emphysema). As a result, gas exchange is greatly reduced, breathing is difficult, and a complication can sometimes be a collapse of the lungs. In special cases, the most damaged part of the lung can be removed with minimally invasive surgery so that the remaining lung works better again and complications can be prevented.

Pulmonary fibrosis

Inflammatory and immunological processes can lead to scarring and hardening of the lungs. At the same time, gas exchange is also disturbed, the respiratory reserve is limited and the heart is strained. Minimally invasive lung tissue harvesting by a thoracic surgeon can be helpful in accurately classifying the type of disease and determining the best medical treatment. Then further treatment is carried out by a pulmonologist.

Paralysis of the diaphragm

Paralysis of one of the two phrenic nerves may result from accidents, operations or other rare causes. The diaphragm on the affected side relaxes and rises towards the chest. As a result, breathing, heart function, and sometimes digestion are disturbed. This can be corrected by surgical plication of the diaphragm, which is also usually minimally invasive.

High level of expertise in the correction of chest deformities and pectus excavatum

The so-called pectus excavatum is a developmental disorder of the costal cartilages and usually consists of a depression in the lower part of the sternum. In addition to the sometimes disturbing cosmetic aspect, cardiac function or lung capacity may be more severely limited. Large-scale corrective operations, which were mainly applied in the past, are now extremely rare. Today, the so-called Nass operation, named after its inventor, South African pediatric surgeon Donald Nass, is considered the gold standard. In this minimally invasive technique, a custom-made metal rod is placed under the sternum under visual control, and the sternum is lifted forward. This metal part remains in the body for several years before it can be removed. Prof. Müller’s team has been using a modification of the classic Nass method for many years with great success, which causes significantly fewer complaints and uses less metal.

Treatment for excessive sweating: endoscopic sympathetic clipping

If patients complain of excessive sweating, especially on the hands and armpits, even without strenuous exercise, this is known as hyperhidrosis. In general, young people often suffer from this problem, which can cause stress in both personal and professional life. Many years of treatment with ointments, tinctures and Botox injections often do not lead to a satisfactory result. Very little surgery – please only by a truly specialized thoracic surgeon – can result in immediate and permanent relief of symptoms. With the right method, the side effect of increased sweating in other places, which has sometimes been observed in the past, almost never occurs.

Team led by prof. Dr. Muller opens up new horizons. During the operation, the so-called sympathetic nerve (marginal trunk) is blocked from the side of the chest with a 5-mm camera using small titanium clamps, and not, as is often described, by cutting. As a result, side effects have become extremely rare, and if necessary, the metal clip can even be removed again.

Interdisciplinary collaboration for personalized care

An interdisciplinary tumor board has been set up at the Pulmonary Center of the Döbling Private Hospital in Vienna to provide patients with lung cancer and other malignant diseases with the best possible therapy. Experts from a wide variety of fields advise each individual patient on the state of health, as well as the feasibility and prospects for success of all available therapy options. This interdisciplinary exchange of experience between medical colleagues serves to maximize patient safety and optimize individual therapy.

More information can be found on the website of prof. University, Dr. Michael Rolf Müller and on the website of the Pulmonology Center in the private clinic in Döbling.

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