Thoracic surgery involves procedures on organs within the chest, primarily the lungs, esophagus, and chest wall. Selecting the right surgeon for this procedure is an important decision for patients and their families. This selection requires evaluating specific measures of training, experience, and the infrastructure supporting the surgeon. The following criteria provide actionable steps for an informed evaluation.
Essential Credentials and Training
A foundational step in evaluating a potential thoracic surgeon is confirming their formal credentials. Every practicing surgeon must hold a current and unrestricted medical license, which can be verified through the state’s medical board website. Beyond licensing, successful completion of an accredited residency program is required for specialized practice.
The most recognized marker of expertise is board certification by the American Board of Thoracic Surgery (ABTS). Achieving ABTS certification signifies that the surgeon has completed a rigorous training pathway, which may include a general surgery residency followed by a thoracic surgery residency, or a six-year integrated program. Certification requires passing comprehensive written and oral examinations. Surgeons must also participate in ongoing continuing certification activities to maintain their status.
Assessing Surgical Volume and Specialization
The frequency with which a surgeon performs a specific operation, known as surgical volume, is tied to patient outcomes for complex procedures. For operations like a video-assisted thoracoscopic surgery (VATS) lobectomy or an esophageal resection, repeated experience correlates with reduced complication rates and better survival. Patients should directly inquire about the surgeon’s personal case volume for the exact procedure they require, not just their general thoracic surgery volume.
A high-volume center for lung cancer surgery performs at least 20 such procedures annually. While defining a specific cutoff for individual surgeon volume remains debated, a higher personal case count is preferred. Furthermore, inquire about the surgeon’s specialization; some focus broadly on general thoracic issues, while others concentrate on sub-areas like lung cancer, esophageal diseases, or transplantation. A surgeon who concentrates their practice on a narrow set of procedures is likely to have deeper experience in that specific area.
The Role of the Medical Center
The skill of the surgeon is only one component of a successful outcome; the hospital environment and support system are equally important for complex thoracic procedures. Patients should investigate the quality and resources of the medical center where the surgery will take place. Higher-volume hospitals, which may perform 150 or more lung resections a year, are associated with lower mortality rates, due to superior infrastructure and resources.
Complex surgeries require immediate access to a specialized support network, including a dedicated Cardiothoracic Intensive Care Unit (CTICU) staffed by critical care physicians, known as intensivists, and specialized nurses. The presence of a multidisciplinary team is also important, especially for cancer cases. This team typically includes the surgeon, medical oncologists, radiation oncologists, and pulmonologists who meet to discuss the patient’s treatment plan, which has been shown to improve outcomes.
Patient Experience and Decision Making
After assessing objective factors like credentials and volume, evaluate the subjective fit. Seeking a second opinion is advisable, providing a comprehensive view of treatment options and allowing for a comparison of communication styles. The surgeon should be able to clearly articulate the proposed surgical approach, such as whether a minimally invasive technique like VATS or robotic surgery is an option, and the rationale for their recommendation.
It is important to ask questions about the surgeon’s complication rates for the specific procedure, as well as the expected length of the hospital stay and recovery timeline. Patients should evaluate the surgeon’s willingness to answer questions and their ability to explain complex medical information clearly and patiently. A surgeon who demonstrates open communication and a clear plan for post-operative and follow-up care is an important aspect of the patient’s overall experience.