Thoracic Surgery Course

Lesson 1 • Mediastinal Compartments and Contents

Describes anterior, middle, and posterior mediastinal zones and their key structures. Guides surgical approach selection for mediastinal pathology.

Lesson 2 • Pleural Spaces and Diaphragm

Defines parietal and visceral pleura, costophrenic recesses, and diaphragmatic attachments. Critical for understanding pleural pathology and drainage procedures.

Lesson 3 • Thoracic Vascular and Nerve Supply

Maps bronchial arteries, pulmonary vasculature, and thoracic autonomic nerves. Essential for hemorrhage control and nerve-sparing techniques.

Lesson 4 • Pulmonary Lobar and Segmental Anatomy

Details bronchopulmonary segments, fissures, and hilar structures. Provides the anatomical basis for segmentectomy and lobectomy planning.

Lesson 1 • Respiratory Mechanics and Gas Exchange

Reviews lung volumes, compliance, airway resistance, and ventilation-perfusion matching. Provides the physiological basis for interpreting pulmonary function tests.

Lesson 2 • Imaging and Staging Workup

Integrates CT, PET-CT, and MRI findings into surgical planning and oncologic staging. Ensures accurate disease characterization before operative commitment.

Lesson 3 • Pulmonary Function Testing Interpretation

Teaches spirometry, diffusion capacity, and exercise testing analysis. Directly informs resectability decisions and postoperative lung function prediction.

Lesson 4 • Preoperative Optimization Strategies

Covers smoking cessation, pulmonary rehabilitation, nutritional support, and medication management. Reduces postoperative complications through targeted prehabilitation.

Lesson 1 • Emergence and Extubation Considerations

Addresses criteria for safe extubation, management of air leaks, and transition to postoperative ventilation. Prevents respiratory failure in the immediate postoperative period.

Lesson 2 • Regional Anesthesia and Pain Control

Describes thoracic epidural, paravertebral block, and intercostal nerve block techniques. Reduces opioid requirements and facilitates early postoperative mobilization.

Lesson 3 • Intraoperative Monitoring and Hemodynamic Management

Covers arterial lines, central venous access, and cardiac output monitoring during thoracic cases. Guides fluid management and vasopressor use in the lateral decubitus position.

Lesson 4 • Double-Lumen Tube Placement and Confirmation

Details left and right double-lumen tube selection, insertion technique, and fiberoptic confirmation. Ensures reliable lung isolation before surgical incision.

Lesson 1 • Exposure Optimization and Troubleshooting

Addresses lung retraction, adhesiolysis, and management of difficult exposure in all approaches. Prevents inadvertent injury during access and improves operative efficiency.

Lesson 2 • Posterolateral Thoracotomy Technique

Covers patient positioning, muscle-sparing options, rib spreading, and closure for posterolateral thoracotomy. The standard open approach for major pulmonary and esophageal resections.

Lesson 3 • Video-Assisted Thoracoscopic Surgery Port Placement

Defines standard and uniportal VATS configurations, trocar selection, and camera positioning. Establishes the technical foundation for minimally invasive thoracic procedures.

Lesson 4 • Robotic Thoracic Surgery Setup

Covers robotic system docking, arm configuration, and instrument selection for thoracic procedures. Prepares surgeons for robotic-assisted lobectomy and mediastinal surgery.

Lesson 1 • Pneumonectomy and Sleeve Resection

Addresses intrapericardial vessel control, bronchial stump management, and sleeve bronchoplasty for advanced resections. Extends resectability while preserving lung function where possible.

Lesson 2 • Anatomic Segmentectomy

Covers intersegmental plane identification, bronchial and vascular division, and parenchymal transection for segmentectomy. Increasingly preferred for small peripheral lung cancers.

Lesson 3 • Wedge Resection and Stapling Techniques

Teaches parenchymal stapling, margin assessment, and indications for wedge resection. Foundational technique applicable to diagnostic and therapeutic pulmonary procedures.

Lesson 4 • Lobectomy: Hilar Dissection and Vascular Control

Details systematic hilar dissection, individual vessel ligation, and bronchial division for lobectomy. The standard curative resection for early-stage non-small cell lung cancer.

Lesson 1 • Posterior Mediastinal and Neurogenic Tumors

Addresses paravertebral tumor dissection, spinal canal involvement assessment, and combined thoracic-neurosurgical approaches. Prevents neurological injury during posterior mediastinal resection.

Lesson 2 • Anterior Mediastinal Mass Resection

Covers thymoma, teratoma, and lymphoma surgical management including en bloc resection principles. Requires integration of preoperative staging and approach selection.

Lesson 3 • Pleurodesis and Pleural Tumor Surgery

Teaches talc pleurodesis, pleurectomy, and cytoreductive surgery for malignant pleural mesothelioma. Balances oncologic goals with preservation of quality of life.

Lesson 4 • Thymectomy for Myasthenia Gravis

Details extended thymectomy technique, ectopic thymic tissue removal, and perioperative myasthenic crisis management. Optimizes neurological outcomes through complete gland excision.

Lesson 1 • Esophageal Anatomy and Physiology Review

Reviews esophageal layers, blood supply, lymphatic drainage, and motility physiology. Provides the anatomical basis for safe esophageal dissection and anastomosis.

Lesson 2 • Minimally Invasive Esophagectomy

Covers laparoscopic abdominal phase, thoracoscopic esophageal dissection, and anastomotic technique for minimally invasive esophagectomy. Reduces pulmonary complications versus open approaches.

Lesson 3 • Ivor Lewis and McKeown Esophagectomy

Details abdominal mobilization, thoracic esophageal dissection, and intrathoracic anastomosis for Ivor Lewis esophagectomy. The most widely performed approach for mid and distal esophageal cancer.

Lesson 4 • Antireflux and Hiatal Hernia Surgery

Teaches Nissen fundoplication, Toupet repair, and hiatal hernia reduction with crural closure. Addresses the most common benign esophageal surgical conditions.

Lesson 1 • Anastomotic and Bronchial Stump Complications

Teaches recognition and management of anastomotic leak, bronchopleural fistula, and empyema after resection. Guides endoscopic, interventional, and surgical salvage strategies.

Lesson 2 • Cardiovascular Complications

Covers postoperative atrial fibrillation, cardiac herniation, and pulmonary embolism recognition and treatment. Identifies life-threatening events requiring urgent intervention.

Lesson 3 • Enhanced Recovery and Discharge Planning

Implements enhanced recovery after thoracic surgery protocols including early mobilization, nutrition, and pain management. Reduces hospital stay and improves patient-reported outcomes.

Lesson 4 • Chest Tube Management and Removal

Covers chest tube placement, drainage monitoring, air leak grading, and safe removal criteria. Directly impacts length of stay and prevention of retained hemothorax.