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CentraState lung cancer surgeons pioneers in video-assisted surgery CANCER CARE 2018

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Receiving a lung cancer diagnosis is devastating but learning there is a procedure that is minimally invasive, offers shorter recovery time with less pain and fewer complications, as compared with a traditional painful and more invasive open chest thoracotomy, is welcome news.

The thoracic surgeons at CentraState Medical Center are pioneers of VATS (Video Assisted Thoracic Surgery). In fact, Dr. Jean-Philippe Bocage, along with his partner, Dr. Robert Caccavale, learned the technique 25 years ago during his thoracic surgical residency. Now, he said, VATS is the preferred option for patients requiring surgical chest procedures at CentraState Medical Center in Freehold.

Bocage and Caccavale have performed over 8,000 VATS procedures, approximately 400 procedures, annually. He is proud to say that fewer than 1 percent of all of these surgeries have been converted to open-chest thoracotomies.

“There are other surgeons that claim to do VATS, but their conversion rate [to open chest procedures] is much higher than ours,” said Bocage. He credits CentraState’s multidisciplinary approach to cancer diagnosis and treatment with early detection that often makes VATS so successful.

"Everyone from the anesthesiologist, to the operating room nurses, to the postop professionals work closely as a team. There are no surprises."

Dr. Jean-Philippe Bocage

Additionally, the surgeon said, all members of his surgical team have considerable experience performing the VATS procedure. “Everyone from the anesthesiologist, to the operating room nurses, to the postop professionals work closely as a team. There are no surprises,” he said.

VATS is a “better option than the traditional thoracotomy,” Bocage said, noting the key benefits are many.

Instead of the 10- to 14-inch incision required by a traditional open-chest surgical procedure, doctors make four one-inch incisions during VATS. This reduces the possibility of injuring the patient’s ribs or chest muscles during the surgery, Bocage explained. The reduced trauma to the chest wall is a benefit, especially in patients with emphysema. It minimizes the work of breathing and potential complications.

Further, VATS usually requires no more than a two-day hospital stay (often patients are discharged after one day) while a traditional thoracotomy can require a hospital stay of up to 10 days.

Recovery time with VATS is “markedly reduced” and there is a significantly reduced complication rate. “Patients are able to return to normal function quicker (a couple of weeks vs. a couple of months) after VATS,” he said. “Also, less than 5 percent of VATS patients experience post-surgery complications, compared to 30 percent of thoracotomy patients.”

Almost all patients with a lesion on their lung are eligible for VATS, he said.

“There are no contraindications for having a surgical chest procedure done by VATS. In fact, one of the only reasons a patient might not be a candidate is if the size of the tumor requires a large incision,” he said. Cancerous lesions that measure greater than five centimeters are more likely to require an open surgical procedure.

This fact is one of the major reasons why Bocage is a huge proponent of lung screenings, particularly at CentraState Medical Center.

“CentraState’s lung screening program is outstanding, one of the very best in New Jersey, he said. “This program is very effective in diagnosing lung cancer at a very early stage.”

And, when lung cancer is diagnosed very early, VATS is particularly successful.

“If lung cancer is diagnosed at Stage 1 and the tumor is removed with VATS, it’s quite possible the patient will need follow-up but not require radiation or chemotherapy,” Bocage said. “That’s why CentraState’s lung screening program is particularly beneficial.”

To qualify for a lung screening through the Comprehensive Lung Care Program at CentraState Medical Center, patients must meet all the following criteria.

Must not have known nodules in the chest;

Be a current smoker or have quit within the last 15 years;

Must have no symptoms of lung cancer;

Have smoked one pack of cigarettes a day for 30 years, two packs a day for 15 years, etc.;

Be age 55-80 (50-77 for Medicare patients); and

Have a prescription for a low-dose CT scan for lung screening.

Once admitted to the screening program, patients will be eligible to be screened by CT scan annually as long as they meet the stated criteria.

For Bocage, there is no question about it. If someone is facing a diagnosis of lung cancer, They should speak with their surgeon about VATS.

“Simply put, VATS minimizes surgical and health risks,” he concluded. “It allows for a speedier recovery with less scarring, less pain, and less complications.” And, long-term results are better than standard thorocatomy. 

For more information about CentraState’s lung screening program, call (866) CENTRA7. To find out more about VATS and Dr. Bocage’s team, visit www.centrastate.com/lungcancer.

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