Thoracic Surgery

India's Largest Volume, Comprehensive Chest Surgery & Chest Onco-Surgery Centre

Sir Ganga Ram Hospital, New Delhi has an established Institute of Chest Surgery with a dedicated team of Thoracic Surgeons offering comprehensive Surgical Chest Care involving the organs of the thorax, including the esophagus, trachea and the chest wall. We work closely with our expert colleagues in Pulmonology, Medicine, Gastroenterology, Critical care, Medical oncology, Radiologist and other specialities for comprehensive, innovative and supportive care to our patients. Our patients are pain free in the post operative period due to extensive support from the pain medicine department. We have dedicated respiratory therapist for our patients who helps them come out of the bed on same or first post operative day. The nurse coordinators helps the patients understand their treatment, schedule their multiple test and address their needs.

The method of surgery has been very versatile. We offer open method of surgery, Video-assisted thoracoscopic surgery (VATS) and Robotic surgery according to different surgical conditions. We have wide spectrum of surgical conditions.

We pride ourselves on using evidence based medicine and cutting edge technology to provide the best care possible to our patients. Our mission is to compassionately restore the fullness of health to patients through surgical excellence, technology and dedication.

India’s first accredited 3 year’s Training Program in Thoracic Surgery i.e. DNBE (Post M.S./DNBE in General Surgery) was started by the National Board of Examinations at Centre for Chest Surgery at Sir Ganga Ram Hospital in January 2014.

The team offers surgeries for the entire spectrum of surgical chest diseases:

Lungs

• VATS Lobectomy, Pneumonectomy and Sub-Lobar resections for Lung Cancer and Carcinoids.
• Complex lung resections for carcinoma and other tumours including chest wall resections.
• Parenchyma preserving surgery for Lung cancer- “Sleeve Resections”.
• Resection of pulmonary secondaries -“Pulmonary Metastatectomy”.
• Lung Volume Reduction Surgery (LVRS) for Emphysema.
• Bullectomy and Blebectomy for Bullous Lung disease.
• Lung resections for Hydatid Cyst and other cystic lung diseases.
• Lung resections for Aspergilloma, Mucormycosis and other fungal infections.
• Lung resections for Tuberculosis and its complications.
• Lung resections for Congentinal Cystic Adenomatoid Malformation (CCAM) and Congenital Lobar Emphysema (CLE).

Oesophagus

• VATS and Open Oesophageal resections for malignancy.
• Surgery for benign oesophageal disorders.
• Surgery for Corrosive strictures of Oesophagus.
• Surgery for Oesophageo-tracheal fistula.
• Surgery for Oesophageal and Foregut duplication cysts.
• Surgery for Oesophageal Motility disorders.

Pleura

• Surgery for pleural diseases such as empyema and papapneumonic loculated effusions - “Decortication”.
• Surgery for Hemothorax and Chylothorax.
• Tumors of Pleura Pleural biopsy Pleurectomy Pleurodesis for Malignant Pleural.

Trachea

• Tracheal resections for strictures or stenosis, tumours and trauma.
• Surgery for Tracheo-Oesophageal Fistula.
• Surgery for Tracheomalacia.

Mediastinum

• Mediastinal tumour Resection (VATS and open surgery).
• Thymectomy: Surgery for Myasthenia Gravis and Thymic Tumor (Thymoma, Thymic Carcinoma).
• Surgery for Pediatric Neurogenic tumors and cysts of the mediastinum.
• Surgery for Ectopic Parathyroid Adenomas.

Chest wall

• Surgery for Chest wall tumors (Bone and Soft tissue tumors).
• Surgery for Chest trauma and rib fractures.
• Rib fixation for Flail Chest.
• Surgery for Congenital Chest deformities - Pectus Excavatum and Pectus Carinatum.

Pericardium

• Surgery for Pericardial Cysts.
• Pericardial Window or Fenestration for recurrent pericardial effusions/tamponade.

Diaphragm

• Surgery for Diaphragmatic Paralysis or palsy - “Plication of diaphragm”.
• Surgery for Diaphragmatic Hernias.
• Surgery for Rupture or tear of diaphragm.

Miscellaneous

• Surgery for Sweaty palms and feet (Hyperhidrosis) - “ Thoracoscopic Sympathectomy”.
• Surgery for Thoracic Outlet Syndrome and Cervical Rib.
• Surgery for Thyroid Cancers and other Thyroid diseases.
• Surgery for Parathyroid diseases.
• Day Care diagnostic thoracoscopy and mediastinoscopy.
• Airway stenting and laser interventions.

Our Commitment

We are offering the best CHEST Surgical care using state-of-the-art Technology at an affordable cost to all our patients.

1. About the Department

The Department of Thoracic Surgery at Sir Ganga Ram Hospital is a high-volume, comprehensive center dedicated to the surgical management of diseases involving the chest, including the lungs, pleura, mediastinum, trachea, esophagus, and chest wall.

Surgical Expertise in Lung and Chest Procedures:

The department offers a full spectrum of thoracic surgical care, ranging from routine to highly complex procedures. Core areas include:

• Lung cancer surgery (lobectomy, pneumonectomy, segmentectomy)
• Esophageal surgeries
• Mediastinal tumor resections
• Pleural diseases (decortication, empyema)
• Chest wall tumors and reconstruction
• Thoracic trauma and rib fixation
• Airway (tracheal) surgeries

Experience in Complex Thoracic Surgeries:

The team has extensive experience in managing advanced and high-risk cases, including:

• Locally advanced thoracic malignancies
• Post-infectious destroyed lungs and sequelae
• Redo thoracic surgeries
• Multisystem trauma involving the chest
• Cases requiring multidisciplinary coordination (oncology, ICU, pulmonology)

There is a strong emphasis on precision, safety, and optimal outcomes, even in challenging surgical scenarios.

Infrastructure and Team Strength

The department is supported by:

• Advanced modular operation theatres equipped for open, VATS, and robotic surgery
• Dedicated Lung ICU with ventilatory support and ECMO capability
• Experienced surgical team, including trained thoracic surgeons, anesthetists, intensivists, and nursing staff
• Respiratory therapists enabling early mobilization and recovery
• Structured perioperative care pathways ensuring smooth patient flow from admission to discharge

Overall, the department combines clinical expertise, advanced technology, and multidisciplinary collaboration to deliver safe, effective, and patient-centered surgical care in all aspects of chest surgery, including readiness for lung transplant programs.

2. Latest Collaboration

The Department of Thoracic Surgery at Sir Ganga Ram Hospital has established a strategic collaboration with KIMS Hospitals to develop a world-class lung transplant program.

Objective of the Collaboration

The primary goal of this partnership is to:

• Establish a comprehensive and sustainable lung transplant program at Sir Ganga Ram Hospital
• Ensure delivery of globally benchmarked surgical care in lung transplantation
• Build institutional capability to manage end-stage lung disease surgically

The collaboration is focused on structured capacity building through:

• Hands-on surgical mentorship by experienced lung transplant teams from KIMS
• Training in donor lung retrieval, preservation, and implantation techniques
• Development of standardized surgical protocols and checklists
• Guidance in perioperative management, including ECMO use and ICU pathways
• Establishing systems for complication management and outcome optimization

Vision for Lung Transplant Program at SGRH

• To create a center of excellence in lung transplantation in North India
• To deliver high-quality, safe, and ethical transplant care
• To integrate multidisciplinary expertise (thoracic surgery, pulmonology, ICU, anesthesia)
• To ensure long-term sustainability with independent surgical capability

This collaboration represents a significant step toward positioning Sir Ganga Ram Hospital as a leading destination for advanced thoracic surgery and lung transplantation in India.

3. Clinical Functions & Scope

The Department of Thoracic Surgery at Sir Ganga Ram Hospital plays a central and definitive role in the lung transplant program, focusing on the surgical execution, intraoperative decision-making, and immediate post-operative care.

Donor Lung Retrieval Process

• Coordination with organ sharing networks and retrieval teams
• Assessment of donor lung suitability intraoperatively
• Surgical retrieval with emphasis on organ preservation and minimal ischemic injury
• Safe transport logistics with preservation protocols

Lung Transplant Surgery (Single/Double Lung)

• Execution of single or bilateral lung transplantation based on recipient condition
• Precise anastomosis of bronchus, pulmonary artery, and pulmonary veins
• Intraoperative strategies to minimize complications such as bleeding and graft dysfunction
• Use of advanced surgical techniques including clamshell incision or minimally invasive approaches (selected cases)

Surgical Planning and Coordination

• Preoperative surgical assessment including imaging review and feasibility
• Coordination with pulmonology, anesthesia, and ICU teams
• Planning for high-risk scenarios, including adhesions, prior surgeries, or pulmonary hypertension

Management of Intraoperative Complexities

• Handling difficult dissections and hemodynamic instability
• Decision-making regarding cardiopulmonary support (ECMO) when required
• Managing size mismatch, bleeding, or technical challenges during implantation

Post-Operative Surgical Care

• Immediate post-surgical monitoring in ICU
• Surveillance for primary graft dysfunction, bleeding, airway complications
• Early interventions such as re-exploration if required
• Coordination with ICU and pulmonology teams for ventilatory strategies and recovery

Overall, the department ensures precision-driven surgical care, seamless coordination, and high standards of safety across the entire transplant pathway, forming the backbone of a successful lung transplant program.

4. The Transplant Journey

The Department of Thoracic Surgery at Sir Ganga Ram Hospital plays a defining role across the surgical timeline of lung transplantation, ensuring precision, coordination, and safety at every step.

Pre-Surgical Evaluation

• Detailed surgical assessment of the recipient, including imaging (CT chest), prior surgeries, and anatomical considerations
• Evaluation of feasibility for single vs. bilateral lung transplant
• Risk stratification for intraoperative challenges (adhesions, pulmonary hypertension, frailty)
• Planning need for intraoperative ECMO or cardiopulmonary support

Donor Matching & Logistics

• Coordination with organ allocation networks for suitable donor lungs
• Matching based on blood group, size compatibility, and urgency
• Organ retrieval planning and transport logistics to minimize ischemia time
• Synchronization of donor and recipient surgical teams

Transplant Surgery Procedure

• Recipient preparation and surgical access (clamshell incision or thoracotomy)
• Explantation of diseased lung(s)
• Implantation of donor lung(s) with bronchial, arterial, and venous anastomosis
• Continuous intraoperative monitoring and decision-making
• Use of ECMO support when indicated

Immediate ICU Care

• Transfer to ICU with ventilatory and hemodynamic support
• Monitoring for primary graft dysfunction, bleeding, and hemodynamic instability
• Early bronchoscopy to assess airway anastomosis
• Gradual weaning from ventilator and ECMO (if used)

Post-Operative Recovery

• Pain control and early mobilization with respiratory physiotherapy
• Chest drain management and monitoring of lung expansion
• Surveillance for surgical complications (air leaks, infections, rejection indicators in coordination with pulmonology)
• Step-down care and discharge planning

This structured surgical pathway ensures a seamless transition from evaluation to recovery, with strong integration between surgery, ICU, and pulmonology—forming the backbone of a successful lung transplant program.

5. Department-Specific Role in Lung Transplant

The Department of Thoracic Surgery at Sir Ganga Ram Hospital plays the lead and decisive role in the lung transplant program, with responsibilities centered around surgical execution, technical precision, and outcome optimization.

Lead Role in Surgical Execution of Transplant

• Primary responsibility for performing single and bilateral lung transplant surgeries
• Execution of complex surgical steps including explantation and implantation
• Precision in bronchial, pulmonary arterial, and venous anastomosis
• Ensuring optimal graft function through meticulous surgical technique

Coordination with Donor Networks

• Active coordination with organ allocation and retrieval networks
• Decision-making regarding donor lung acceptance based on intraoperative findings
• Leading or coordinating donor lung retrieval procedures
• Ensuring safe transport and preservation of donor organs

Managing Surgical Risks and Outcomes

• Anticipation and management of intraoperative challenges such as bleeding, adhesions, and hemodynamic instability
• Judicious use of ECMO or cardiopulmonary support when required
• Early identification and management of post-operative surgical complications (bleeding, airway issues, graft dysfunction)
• Continuous evaluation and refinement of surgical outcomes through protocol-based care

Integrated Multidisciplinary Role

• Close coordination with pulmonology, anesthesia, and ICU teams
• Contribution to preoperative surgical planning and recipient selection discussions
• Active involvement in post-operative decision-making for optimal recovery

Overall, the department serves as the core executing unit of the lung transplant program, ensuring that every transplant is performed with maximum safety, precision, and adherence to global standards.

6. Advanced Surgical Capabilities

The Department of Thoracic Surgery at Sir Ganga Ram Hospital is equipped with state-of-the-art surgical technology and advanced perioperative systems, enabling safe management of complex thoracic conditions and lung transplantation.

Minimally Invasive Thoracic Surgery (VATS/Robotic)

• Expertise in Video-Assisted Thoracoscopic Surgery (VATS) for lung resections, pleural diseases, and mediastinal procedures
• Advanced robotic thoracic surgery offering enhanced precision, dexterity, and visualization
• Benefits include smaller incisions, reduced pain, shorter hospital stay, and faster recovery
• Application in both oncological and selected complex thoracic cases

High-End Modular Operation Theatres

• Fully equipped modular OTs designed for complex thoracic and transplant surgeries
• Advanced surgical instruments and imaging integration
• Strict infection control protocols and laminar airflow systems
• Capability to handle prolonged and high-risk procedures like lung transplantation

ECMO Support

• Availability of Extracorporeal Membrane Oxygenation (ECMO) for intraoperative and postoperative support
• Critical for patients with severe respiratory or hemodynamic compromise
• Used as a bridge during lung transplant surgery and in cases of primary graft dysfunction

Advanced Anesthesia& Surgical Monitoring

• Dedicated cardiothoracic anesthesia team experienced in high-risk thoracic procedures
• Continuous hemodynamic and respiratory monitoring including invasive lines and advanced parameters
• Use of lung isolation techniques (double lumen tubes, bronchial blockers)
• Integration with ICU for seamless perioperative care

These advanced capabilities ensure that the department delivers precision-driven, safe, and high-quality surgical care, meeting international standards in thoracic surgery and lung transplantation.

7. A Structured Path to Care

The Department of Thoracic Surgery at Sir Ganga Ram Hospital follows a well-defined, protocol-driven care pathway to ensure seamless, safe, and efficient management of patients undergoing lung transplantation.

Multidisciplinary Board Approach

• All transplant cases are discussed in a multidisciplinary team (MDT) meeting
• Involves thoracic surgeons, pulmonologists, intensivists, anesthetists, radiologists, and transplant coordinators
• Joint decision-making for patient selection, surgical planning, and risk assessment
• Ensures comprehensive evaluation and optimal timing of transplant

Standardized Clinical Protocols (Aligned with KIMS)

• Adoption of evidence-based protocols in collaboration with KIMS Hospitals
• Standardization across:
  • Donor lung retrieval and preservation
  • Surgical techniques and intraoperative management
  • ICU care and ventilatory strategies
• Continuous protocol updates based on outcomes and global best practices

Seamless Patient Journey

• Structured pathway from evaluation → listing → transplant → recovery → follow-up
• Dedicated coordination for:
  • Scheduling investigations and surgical planning
  • Donor-recipient logistics
  • ICU and ward transitions
• Clear communication with patients and families at every stage
• Integration of rehabilitation and long-term follow-up into the care continuum

This structured approach ensures consistency in care delivery, improved surgical outcomes, and enhanced patient experience, forming a strong foundation for a successful lung transplant program.

8. Patient Safety & Quality Benchmarks

The Department of Thoracic Surgery at Sir Ganga Ram Hospital is committed to maintaining the highest standards of patient safety and clinical quality, especially in complex procedures such as lung transplantation.

• Infection Control in Operation Theatres
  • Strict adherence to sterile surgical protocols and aseptic techniques
  • Advanced modular OTs with laminar airflow systems
  • Perioperative antibiotic stewardship and infection surveillance
  • Dedicated protocols to minimize surgical site infections and transplant-related infections
• ICU Outcomes Post-Surgery
  • Specialized thoracic ICU care with trained intensivists and nursing staff
  • Protocol-driven management of ventilation, hemodynamics, and organ support
  • Early detection and management of complications such as:
    • Primary graft dysfunction
    • Bleeding
    • Sepsis
  • Focus on early mobilization and enhanced recovery pathways
• Clinical Governance
  • Regular audit of surgical outcomes and complications
  • Morbidity and mortality (M&M) meetings for continuous quality improvement
  • Data-driven refinement of surgical and ICU protocols
  • Emphasis on accountability, transparency, and continuous learning
• Compliance with Global Transplant Standards
  • Alignment with international lung transplant guidelines and best practices
  • Standardized protocols for:
    • Donor selection and organ preservation
    • Surgical procedures and intraoperative safety
    • Post-transplant monitoring and long-term outcomes
  • Continuous benchmarking against leading global transplant centers

These measures ensure that every patient receives safe, high-quality, and outcome-focused surgical care, reinforcing the department’s commitment to excellence in thoracic surgery and lung transplantation.

9. Why Choose SGRH for Lung Transplant?

Choosing the right center for lung transplantation is critical. The Department of Thoracic Surgery at Sir Ganga Ram Hospital offers a strong surgical advantage backed by expertise, technology, and structured care systems.

• Experienced Thoracic Surgeons
  • Dedicated team with expertise in complex lung and chest surgeries
  • Skilled in high-risk and advanced thoracic procedures, including transplant surgery
  • Strong foundation in minimally invasive and open surgical techniques
• Advanced Surgical Infrastructure
  • State-of-the-art modular operation theatres designed for transplant surgeries
  • Availability of VATS and robotic surgical platforms
  • Integrated thoracic ICU with ventilatory and ECMO support
  • Advanced intraoperative monitoring and anesthesia systems
• Collaboration with KIMS Experts
  • Strategic partnership with KIMS Hospitals
  • Access to experienced lung transplant mentorship and protocols
  • Continuous training, knowledge transfer, and outcome optimization
  • Alignment with established transplant programs and global standards
• High Standards of Surgical Safety
  • Strict adherence to infection control and sterile OT practices
  • Protocol-driven surgical and ICU pathways
  • Continuous monitoring of outcomes, complications, and quality benchmarks
  • Multidisciplinary approach ensuring comprehensive perioperative care

Overall, Sir Ganga Ram Hospital provides a trusted, technologically advanced, and safety-focused surgical environment, making it a strong choice for patients requiring lung transplantation.

10. FAQs

1. What is a lung transplant surgery?

Ans. A lung transplant is a major surgical procedure in which a diseased lung is replaced with a healthy donor lung. It is performed in patients with end-stage lung disease like ILD, COPD, Brochiectasis, Cystic Fibrosis etc. when medical treatment is no longer effective.

2. How long does the surgery take?

Ans. The surgery typically takes 6 to 12 hours, depending on:

• Single vs. double lung transplant
• Patient condition and prior surgeries
• Intraoperative complexities

3. What are the risks of surgery?

Ans. Like any transplant surgery, lung transplant also carries risks such as:

• Bleeding
• Infection
• Primary graft dysfunction
• Rejection
• Complications related to anesthesia or prolonged surgery

4. What is ECMO and when is it used?

Ans. ECMO (Extracorporeal Membrane Oxygenation) is an advanced life-support system that temporarily supports heart and lung function. It is used:

• During surgery in high-risk patients
• Preoperatively, when oxygen levels cannot be maintained
• In early post-operative period if the new lungs need support

5. How long is ICU stay after surgery?

Ans. Typically 5 to 10 days, but may vary. Longer stay may be needed in complex cases or complications.

6. What is recovery time?

Ans. The recovery time varies from patient to patient:

• Initial recovery: 3–6 weeks
• Full recovery and rehabilitation: 3–6 months
• Includes physiotherapy, monitoring, and gradual return to normal activity

7. Are both lungs always replaced?

Ans. The decision is based on disease type and patient condition.

• Single lung transplant – in selected conditions
• Double lung transplant – more common, especially in ILD, infections or bilateral disease.

8. How is donor lung selected?

Ans. Donor lungs are selected based on:

• Blood group compatibility
• Size match with recipient
• Lung function and absence of infection
• Urgency and waiting list priority
• Final decision is often confirmed during retrieval surgery.

9. What are chances of success?

Ans. Success rates are comparable to international standards. Outcomes depend on:

• Patient condition before surgery
• Surgical factors
• Post-operative care and compliance

10. What complications can occur post-surgery?

Ans. Possible complications include:

• Primary graft dysfunction
• Acute or chronic rejection
• Infections (due to immunosuppression)
• Airway complications
• Long-term issues like bronchiolitis obliterans