Our expertise

Phelps Hospital and Northwell Health have a rich history in thoracic surgery. Our surgeons have been at the forefront of leading-edge technology and have pioneered new procedures to bring you the most advanced treatments available. One of the newest methods is robotically assisted thoracic surgery using the da Vinci ® Xi Surgical System.

Performing robotic thoracic surgery

During a robotically assisted thoracic procedure, the surgeon sits at a computer console from which he can see a 3-D image of the lungs or chest area, magnified 10 times greater than a person’s normal vision. The image is projected from a small camera that is inserted through one of several tiny incisions between the ribs. From the console, the surgeon’s hands control delicate instruments attached to the robotic arms to perform the procedure. The surgeon has complete control of the instruments. The robotic arms have a wider range of motion than human hands and translate the surgeon’s larger hand movements into smaller, more precise movements.

Benefits of robotic surgery

Benefits of any type of robotic surgery include:

  • Less blood loss
  • Decreased pain
  • Quicker recovery time
  • Shorter hospital stay
  • Less scarring because of smaller incision

Robotic thoracic procedures

Phelps Hospital and Northwell Health are among only a few health systems or hospitals that offer a broad range of robotic thoracic procedures, including:

Lobectomy involves removal of a section of the lung. It is the most common treatment for lung cancer. For early-stage lung cancer, a minimally invasive approach is performed rather than traditional thoracotomy. The procedure involves making small incisions in the chest through which the surgeon uses the robot to remove the tumor and any unhealthy tissue. Lymph nodes in the mid-chest area are also removed to determine if cancer has spread.

Pneumonectomy is surgery to remove an entire lung.

Esophagectomy, which is usually performed to treat esophageal cancer, involves removal of all or part of the esophagus (the tube that carries food from the throat to the stomach) and then reconstructing it with part of the stomach or large intestine.

Removal of the lower esophagus may be done to treat:

  • Achalasia (nerve damage to the esophagus that causes swallowing difficulty)
  • Barrett’s esophagus (changes to the normal esophageal tissue resulting from a serious complication of GERD)
  • Severe trauma

Heller myotomy is done to correct achalasia. As the muscles of the upper esophagus weaken, they become unable to move food from the esophagus to the stomach. At the same time, the lower esophageal muscle doesn’t totally relax, making it difficult for food to get into the stomach. A Heller myotomy weakens the muscles between the esophagus and the stomach, which helps keep the valve between them open. Surgery is performed through a small incision above the navel.

Thymectomy. Surgical treatment of myasthenia gravis (MG), a neuromuscular disease, is called thymectomy. In MG, the immune system attacks the connections between muscles and nerves, interfering with nerve signals for muscles to relax or contract. Muscles become weak, resulting in symptoms that include double vision or blurred vision (weak eye muscles), drooping eyelids (eyelid weakness), difficulty with speaking and swallowing (throat muscle weakness) and weakness of the limbs. The thymus gland plays a role in MG. When the gland or tumors of the thymus gland (thymomas) are removed, the MG improves.

Repair of hiatal hernia. When the opening (hiatus) in the muscle between the abdomen and diaphragm is too large, it can result in some of the stomach bulging up into the chest and cause gastric acid from the stomach to flow back into the esophagus. Gastric acid in the esophagus causes heartburn that is also known as gastro-esophageal reflux disease or GERD. If left untreated, Barrett’s esophagus can develop, which can lead to esophageal cancer. Hiatal hernia surgery to repair the bulging of the stomach through the muscle can usually be done with small incisions, moving the stomach and lower esophagus back into the abdominal cavity. The surgeon then repairs the opening in the diaphragm and secures the stomach in position to guard against future reflux.

  • para-esophageal hiatal hernia is a hernia in which the gastro-esophageal junction remains attached at the level of the diaphragm, but part of the stomach bulges up next to the esophagus. It can interfere with the passage of food into the stomach. This defect is also corrected minimally invasive.

Sympathectomy is performed to treat hyperhidrosis, or excessive sweating of the underarms, palms or soles of the feet. Sympathetic nerves control sweating, so the surgeon cuts this nerve, disrupting inappropriate electrical activity and relieving the uncontrollable sweating.

Other procedures performed include intra-thoracic biopsies and pleural surgery (in the space between the lung and chest wall).

Robotic thoracic surgery leadership

Darren I. Rohan, MD

Westchester Regional Director
Thoracic Surgery Program

Assistant Professor
Cardiovascular and Thoracic Surgery
Hofstra Northwell School of Medicine

Specialty: Surgery, Thoracic Surgery

Clinical Interest: Robotic and Minimally Invasive Thoracic Surgery, Thoracic Oncology, Lobectomy, Pneumonectomy, Thymectomy, Myasthenia Gravis, Esophagectomy, Heller myotomy, Repair of Paraesophageal Hernia, Tracheobronchoplasty, Achalasia Management, Intrathoracic Biopsies and Pleural Surgery, Thoracic Outlet Syndrome, Pancoast Tumor Excision, Sympathectomy for Hyperhidrosis, Pneumothorax Management, Surveillance Program

Education: MD – University of Miami School of Medicine

Residency: Surgery – Boston Medical Center

Fellowship: Cardiothoracic Surgery – Long Island Jewish Medical Center

Board Certification:

  • American Board of Thoracic Surgery
  • American Board of Surgery

Contact

Darren I. Rohan, MD

Westchester Regional Director
Thoracic Surgery Program

For appointment call (914) 366-1605

Thoracic surgery services are also available at Northern Westchester Hospital, 400 East Main Street, Mt. Kisco, NY. Call (914) 666-1766.