Thoracic Surgical Associates of St. Luke's

Thoracic Surgery

Minimally Invasive Thoracic Surgery

Download and print instructions for:

Download and print instructions for:

Drs. Burfeind and Puc perform video-assisted
thorascopic surgery (VATS) with the help and
support of the surgical care team.

The following procedures can all be performed with a minimally invasive operation. The term minimally invasive is interchangeable with a variety of other commonly used terms such as thoracoscopic or video-assisted thoracoscopic surgery (VATS).

Bullous Disease

When there is destruction of the air sacs within the lung, it can lead to progressive enlargement of the lung, called a bulla. These bullae can enlarge enough to compress adjacent normal lung and cause the patient to have shortness of breath. Bullous disease can also be complicated by infection, coughing up blood and rupture of the bulla. When these complications occur, surgical resection is indicated. A minimally invasive approach to resecting bullous disease is available at St. Luke's Division of Thoracic Surgery.


A standard operation for lung cancer usually requires a formal lobectomy which means removing the entire lobe in which the tumor is found. The thoracic surgeons at St. Luke's perform the majority of their lobectomies with a minimally invasive approach. Minimally invasive lobectomy can be performed for lung cancer, but also can be used for non-malignant reasons.

Lung Biopsy

Lung biopsies are required for various reasons such as removing lung nodules or to diagnose interstitial lung disease. If your physician requires a portion of lung tissue to treat your pulmonary condition, he/she can refer them to a thoracic surgeon at St. Luke's for a minimally-invasive video-assisted lung biopsy. This procedure usually requires only two small incisions and an overnight stay in the hospital. The lung tissue is then sent to the pathology department, which processes the tissue and determines the diagnosis based on their findings.

Pleural Biopsy

A pleural biopsy is a technique used to sample the tissue lining the chest wall. This can be performed as an individual procedure or performed during the course of a different procedure in the chest. This procedure can be performed with one or two small incisions utilizing a minimally invasive approach.

Pleural and Pericardial Effusions

Fluid can develop around the lung or the heart for a variety of reasons. If the fluid is causing symptoms such as shortness of breath or if the fluid needs to be tested to help identify its cause, we can drain the fluid using video-assisted thoracoscopic surgery (VATS). The thoracic surgeons at St. Luke's also have extensive experience with the Pleurx catheter that is an indwelling chest tube that patients can go home with. The best candidates for this catheter can be determined by consultation with a thoracic surgeon. Whatever your particular situation, we can develop a unique treatment plan that will best manage or eliminate the fluid.

Spontaneous Pneumothorax

A spontaneous pneumothorax occurs when the surface of the lung ruptures and allows air that is normally in the lung escape outside around the lung. This will cause your lung to collapse and may produce pain and shortness of breath. Treatment usually requires removal of the air with a chest tube, allowing the rupture point to seal on its own. Occasional an operation is required when the leak will not seal or you have experienced multiple pnuemothoraces. A minimally invasive operation can be performed to eliminate the point of rupture and prevent reoccurrence.


The thymus gland lies behind the upper portion of the breastbone. A thymectomy procedure refers to completely removing the thymus gland. During adulthood the thymus gland normally regresses; so if an adult has an enlarged gland, it generally represents a change that needs to be investigated. A common reason for thymic enlargement is the development of a thymoma within the gland (usually, a low-grade malignancy). There is also significant data to suggest that patients diagnosed with myasthenia gravis will benefit from a thymectomy. The thoracic surgeons at St. Luke's can perform a minimally-invasive thymectomy through a transcervical incision which can sometimes be performed as same-day surgery. A consultation with a St. Luke's thoracic surgeon will help determine if you are a candidate for a minimally-invasive thymectomy.