Stralsund: Innovative lung surgery without general anesthesia
Unlike conventional lung surgery, the patient is not mechanically ventilated through a tube but continues breathing spontaneously during the procedure. This technique is used particularly for critically ill patients. It places less strain on the heart and lungs and reduces potential complications associated with mechanical ventilation. By combining regional anesthesia, sedation, and controlled spontaneous breathing, the procedure can be performed much more gently.
“This procedure is only possible when several highly specialized disciplines work together perfectly,” says Dr. Hussein Abdallah, Senior Consultant Surgeon. Precise coordination between thoracic surgeons, pulmonologists, and anesthesiologists is essential. While the thoracic surgeons perform the minimally invasive procedure, the pulmonologists are responsible for precise diagnostics and determining the indication for surgery. At the same time, the anesthesiologists take on a particularly demanding task: they ensure safe analgesic sedation without impairing the patient’s spontaneous breathing. “Managing anesthesia in such a procedure is very complex and requires extensive experience in thoracic anesthesia,” explains Dr. Jörg Werner, Chief Physician of Anesthesiology, Intensive Care Medicine, and Pain Therapy.
Procedure for high-risk patients
Heino Rechten benefited from this modern surgical technique for high-risk patients. The 59-year-old moved from Lower Saxony to Barth five years ago “because the air by the water is good for me,” as he says himself. He had already been under the care of a pulmonologist for a long time due to severe lung disease. However, his health condition had progressively worsened. In addition to asthma, his lung volume was severely restricted and had recently fallen to only 48 percent. He suffered from shortness of breath and had very limited physical capacity.
To determine the cause of his symptoms and the exact type of pulmonary scarring (fibrosis), a lung tissue sample was required. “Due to the specific nature of the disease, it was necessary to obtain a relatively large tissue sample from the lung. Because of the severity of the illness and the significantly impaired lung function, taking such a large sample via bronchoscopy would have involved a high risk for the patient,” explains Dr. Christian Warnke, Chief Physician of Pulmonology.
“To nevertheless enable safe and precise diagnostics, a minimally invasive external approach was required. In such cases, NI-VATS offers the possibility of obtaining the necessary tissue sample in a particularly gentle way without placing additional strain on the patient through general anesthesia.”
Minimal discomfort and rapid recovery
For Heino Rechten, the procedure was as gentle as planned. “I didn’t notice anything about the operation or the procedure itself. I also had no pain,” he reports. He was able to leave the hospital after just five days, whereas up to ten days may be required for comparable procedures.
The patient was especially impressed by the medical care: “I was very well informed and treated. I was very grateful that Dr. Abdallah, as promised, called my wife immediately after the procedure and informed her about how everything had gone. That gave us a very reassuring feeling.”
He is now awaiting the histological results of the tissue sample.
State-of-the-art medicine close to home
“The first-time use of this surgical method is far more than an isolated medical case. It demonstrates that highly advanced thoracic surgical procedures can also be offered close to home in the region,” says Prof. Matthias Birth, Medical Director and Chief Physician of Surgery at the hospital.
Everyone involved can be proud of this achievement. Behind this success lies not the work of one individual, but the commitment of an interdisciplinary team making state-of-the-art medicine available in the Vorpommern-Rügen region.
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