Thoracic division members
The scope of thoracic anesthesia includes anesthetic care of thoracic and fore-gut surgery patients. With the addition of two thoracic surgeons, the scope of thoracic anesthesia and surgery has expanded at the University of Rochester Medical Center. In addition to a variety of fore-gut surgery (e.g. esophageal cancer, gastroesophageal reflux disease, and Achalasia), anesthesia for thoracic surgery includes lobectomy and pneumonectomy, airway stents and laser, mediastinal tumors and thymectomy, and chest cavity procedures (e.g. empyema). The Division of Thoracic Anesthesia also provides ample opportunity for anesthetic care of patients undergoing thoracic surgery using minimally invasive techniques (e.g. Endobronchial Ultrasound-guided Mediastinal Lymph node aspiration biopsy (EBUS), Video-assisted thoracoscopic surgery (VATS), and minimally invasive esophagectomy. State-of the-art digital video and fiberoptic equipment is used for lung isolation techniques.
A formal 2-week Thoracic Anesthesia rotation is offered to residents at each level of training (CA-1, CA-2, and CA-3). The CA-3 Thoracic Anesthesia Rotation is a senior resident rotation with emphasis on more advanced skills and more autonomy. The goals of the Thoracic Anesthesia rotation are to provide residents with the basic science foundation in respiratory physiology, and skills and clinical experience to care for patients requiring thoracic (non-cardiac) surgical procedures. Integral to this goal is for the resident to become competent as a consultant in anesthesiology in pre-anesthetic evaluation of pulmonary function, formulation and safe conduct of an anesthetic plan including control of postoperative pain, management of one-lung anesthesia and lung isolation, and skills in fiberoptic bronchoscopy. The didactic teaching includes 1-1 teaching by the thoracic anesthesia faculty in the operating room and a reference "Thoracic Anesthesia Manual" which consists of applied respiratory physiology of one-lung anesthesia, technical aspects of lung isolation, as well as "state-of-the-art" reviews in thoracic anesthesia. Over the last two years, we added a "Thoracic Anesthesia Workshop" for the rotating residents to master fiberoptic bronchoscopy skills required in positioning and trouble-shooting double-lumen tubes as well as hands-on training with lung isolation equipment. This allows the residents to learn the concepts and reinforce their skills in a more relaxed and non-stressful environment. Thoracic anesthesia rotations include pre- and post-testing as part of the evaluation process, reading assignments, and OR experience. Residents have consistently rated the rotations high for their teaching quality and utility.