Treatment of lung abscess with partial or wedge resection

About the department

The Department of Thoracic Surgery at the Luisenhospital Aachen offers top-class surgical treatment for benign and malignant diseases of the lungs, bronchi, pleura, mediastinum, and diaphragm. During the treatment, the doctors cooperate closely with pulmonologists, physiotherapists, and specialists in the field of respiratory gymnastics. Such an approach guarantees the patient a comprehensive diagnosis before the operation using imaging tests, endoscopic examinations, and pulmonary function tests, as well as postoperative rehabilitation, in which pulmonologists and physiotherapists are actively involved. In complex clinical cases, medical boards are held with the participation of thoracic surgeons and pulmonologists, who cooperatively elaborate an optimal treatment regimen. The team of the department's thoracic surgeons brilliantly performs minimally traumatic and classic open operations on the chest organs, excluding the heart. A special offer in the department is robot-assisted surgery using the innovative da Vinci system. The specialists of the medical facility always strive to perform minimally traumatic surgical treatment. The department has vast experience in interventions for pneumothorax, pleurisy, pulmonary emphysema, lung cancer, lung metastases, pleural mesothelioma, and other diseases. The department has at its disposal state-of-the-art technical resources and highly qualified experts, whose main value is the patient's health. The Head Physician of the department is PD Dr. med. Ingo-Michael Krueger.

The department's surgeons treat many patients with benign lung diseases. Surgical interventions for pneumothorax, pleurisy, pulmonary emphysema, and pleural empyema are regularly performed here. Pneumothorax is a pathological accumulation of air in the pleural cavity, leading to chest pain, breathing difficulties, shortness of breath, dry cough, and palpitations. When detected in the early stages, the department's specialists carry out a puncture followed by drainage. They thus remove the accumulation of air from the pleural cavity. If this treatment option is not suitable for the patient for clinical indications, surgery is performed, namely thoracoscopic resection of the upper lobe of the lung in combination with partial pleurectomy (removal of the pleura). Pleurisy is an accumulation of exudate, pus, or blood in the pleural cavity due to inflammation or other systemic diseases. To treat pleurisy, the department's thoracic surgeons most often perform a minimally traumatic intervention to implant a permanent pleural catheter. Thoracoscopic pleurodesis is another effective treatment option.

As for malignant diseases, the team of thoracic surgeons specializes in the treatment of lung cancer, lung metastases, and pleural mesothelioma. Lung cancer is one of the most common types of cancer worldwide. The most effective treatment method is surgical resection of the malignant tumor or the affected lung lobe. The department's specialists successfully operate on patients with lung cancer using thoracoscopic and open anatomical resections and angioplastic, bronchoplastic, and extended pericardial resections. Lung metastases can be removed using thoracoscopic and laser techniques. Laser resection is performed even in the presence of multiple lung metastases. During the treatment of pleural mesothelioma, the department's specialists resort to pleurectomy or extended pleuropneumonectomy. Whenever possible, lung and pleural cancer surgery is performed using minimally invasive techniques without a thoracotomy.

The department's operating room is equipped with an innovative da Vinci surgical system designed for performing high-precision minimally invasive interventions. Robot-assisted surgery is available only in a few European hospitals due to the relatively high cost of the device and the need for surgeons to undergo extensive training to master the technique. The Head Physician of the department, Dr. med. Ingo-Michael Krueger, is the co-founder of the Working Group on Robotic Surgery of the German Society for Thoracic Surgery. He has impressive experience in robot-assisted surgical interventions and trains other doctors how to operate the device. The da Vinci surgical system consists of three units: the video stand, the console for patients, and the console for surgeons. It is important to realize that the robot does not perform any surgical manipulations on its own but only follows the commands given to it by the surgeon using the control console. The robot is equipped with four "arms'' with miniature surgical instruments and a camera fixed in them. The "arms" of the da Vinci robot fully imitate the movements of the human hand but have no tremors or involuntary movements. The built-in camera in one of the "hands" of the robot provides real-time 3D imaging of the surgical field, so that the surgeon controlling the robot can clearly see the slightest anatomical structures. Robot-assisted interventions are performed through a minimally invasive approach (1-2 cm incisions). Thus, after robot-assisted interventions, the patient experiences virtually no pain in the postoperative period and quickly recovers. In addition, such operations leave barely noticeable scars.

The department's key focuses include:

• Surgical treatment of pneumothorax
  • Drainage
  • Thoracoscopic resection of the upper lobe of the lung in combination with partial pleurectomy
• Surgical treatment of pleurisy
  • Permanent pleural catheter placement
  • Thoracoscopic pleurodesis
• Surgical treatment of emphysema
  • Lung volume reduction followed by plastic reconstruction
• Surgical treatment of pleural empyema
  • Drainage with local fibrinolysis
  • Thoracoscopic surgery
  • Thoracoscopic and classical open decortication
• Surgical treatment of lung cancer
  • Thoracoscopic or open anatomic resections
  • Angioplastic, bronchoplastic, and extended pericardial resections
• Surgical treatment of lung metastases
  • Thoracoscopic resection
  • Laser resection
• Surgical treatment of pleural mesothelioma
  • Palliative pleurodesis
  • Abdominal and parietal pleurectomy
  • Extended intrapericardial pleuropneumonectomy
• Surgical treatment of other diseases of the respiratory system