Diseases and… Departments

Departments

The close and efficient interdisciplinary cooperation of the departments presented is an attribute most advantageous to the patients. Thoraxklinik Heidelberg Department Heads and Seniors are renowned world-wide. They are heading organizations and committees dedicated to improving care and advancing knowledge and guidelines within their specialities.

Univ.-Prof. Dr. med. Hauke Winter

Head of Department (Thoraxchirurgie)

Thoracic surgery - A Highly Trained Surgical Team: 

The large team of thoracic surgeons perform 2,300 operations per year, in both pediatric and adult patients.  About 40% of the procedures nowadays are carried out as minimally invasive videothoracoscopy. Open thoracotomy is used to address invasive tumor growth, and for multivisceral resections. Reconstructive surgery is performed on the chest wall or on the tracheobronchial system, including so-called sleeve resections conducted to spare the patient an unnecessary loss of lung tissue.  

Medical Conditions

  • Pulmonary carcinoma
  • Pulmonary metastases
  • Pleural effusion
  • Emphysema
  • Pleural mesothelioma
  • Thoracic wall deformities (sunken chest, pigeon chest)
  • Tracheal conditions
  • Thymic carcinoma / myasthenia
  • Also childhood sarcomata
  • Tumors of the chest wall
  • Mediastinal tumors
  • Pancoast tumors
  • Pleural mesothelioma

Services:

  • Video-assisted minimal invasive techniques (“keyhole surgery”) – uniportal / multiportal
  • Standard open procedures (“thoracotomy”)
  • Complex multivisceral resection and reconstructive procedures to the chest wall
  • Radiofrequency ablation (RFA) -> Prof. Heussel
  • Laser surgery
  • Plastic surgery to the chest wall
  • Plastic closure surgery to the chest wall
  • DaVinci surgical robot system
  • Lung volume reduction
  • Pulmonary empyema surgery
  • Tracheal resection
  • Port implantation
  • Surgery under ECMO
  • Diaphragmatic plication
  • HITHOC – Hyperthermic intrathoracic chemotherapy perfusion
  • Pleurectomy, P3D procedure
  • Mediastinoscopy

Where required, surgical procedures are performed jointly with related surgical departments of the University of Heidelberg (Plastic Surgery, Orthopedics, Neurosurgery, Cardiac Surgery, Intestinal Surgery).

Univ.-Prof. Dr. med. Felix Herth

Head of Department (Pneumologie und Beatmungsmedizin)

Pneumology and respiratory medicine - Specialists in Pneumology and Ventilatory Support: 

The Department of Pulmonary and Respiratory Critical Care Medicine focuses on the diagnosis and therapy of respiratory tract diseases such as lung emphysema, cystic fibrosis, fibrosing alveolitis, and pulmonary hypertension; on non-invasive ventilatory support for patients with respiratory deficiency or failure; on sleep related respiratory disorders. An outstanding expertise is provided in all fields of bronchoscopy, taking a lead position in the development of devices for diagnostic and therapeutic purposes.

Medical Conditions

Benign pulmonary conditions

  • Bronchial asthma
  • COPD, including lung volume reduction
  • Interstitial lung conditions
  • Sarcoidosis
  • Pulmonary involvement in extrapulmonary conditions such as autoimmune conditions, immune deficiencies, etc.
  • Rare lung conditions
  • Complex infections, pneumonias and tuberculosis
  • Diagnosis and treatment of non-tubercular mycobacterioses
  • Bronchiectasis conditions including mucoviscidosis
  • Infections in HIV / AIDS patients
  • Pulmonary hypertension

Malignant pulmonary conditions

  • Diagnosis and staging of patients with lung cancer and other bronchopulmonary tumors
  • Preoperative function diagnostics
  • Diagnosis and staging of primary pleural mesothelioma and secondary pleural tumors
  • Diagnosis and staging of pulmonary metastasized, extrathoracic tumors

Special clinic / center services

  • Accredited by the European Reference Network for interstitial pulmonary conditions (ERN-LUNG)
  • Interdisciplinary diagnosis of complex pulmonary conditions
  • Right heart catheter

Endoscopy

  • Rigid / flexible bronchoscopy
  • Pediatric bronchoscopy
  • Endosonography (endonbronchial / endoesophageal)
  • Navigated bronchoscopy
  • Interventional bronchology therapy (laser, electrocoagulation, stent implantation, brachytherapy with intrabronchial irradiation)
  • Endoscopic lung volume reduction
  • Endoscopic asthma therapy, internistic thoracoscopy (pleural inspection) for the clarification and treatment of pleural effusion

Respiratory medicine

  • Treatment of patients with home mechanical ventilation for chronic respiratory insufficiency
  • Non-invasive mask ventilation for acute and chronic respiratory muscle weakness
  • “Weaning” (ventilator weaning) for patients with long-term ventilation

Sleep medicine

  • Accredited by the German Sleep Research and Sleep Medicine Association
  • Diagnosis and treatment of sleep-related respiratory disorders

Cardiopulmonary function laboratory

  • Body plethysmography
  • Spirometry
  • Diffusion capacity
  • Blood gas analysis
  • Specific and nonspecific provocation tests
  • Allergy diagnosis
  • Rhinomanometry
  • Compliance measurement
  • Respiratory effort measurement
  • CO2 rebreathing
  • Long-term EKG at rest and under load
  • Long-term blood pressure measurement
  • Spiroergometry
  • Echocardiography
  • Stress echocardiography
  • Transesophageal echocardiography
  • Doppler thoracic vascular ultrasound
  • Ultrasound-guided lung and pleural puncture
  • Pericardial drainage
  • Right heart catheter
Univ.-Prof. Dr. med. Michael Thomas

Head of Department (Thoraxonkologie)

Thoraxklinik Heidelberg

Thoracic oncology - Competence in Oncology:  

The Thoracic Oncology Team provides the latest options on systemic therapy and multi-modal approaches to care for about 4,800 patients with thoracic malignancies annually. The department is a recognized driver in the conception and execution of clinical trials to improve systemic treatment, and offers appropriately customized treatment approaches to the individual patient, adapted to tumor biology and organ functions.

Medical Conditions

  • All medical conditions and cancer conditions of the chest region (thorax)
  • Non-small-cell carcinoma of the lungs
  • Small-cell carcinoma of the lungs
  • Pancoast tumor
  • Thymic carcinoma
  • Pleural mesothelioma
  • Pulmonary sarcomata
  • Pulmonary metastases of all malignant conditions

Services:

  • Daily interdisciplinary case conferences
  • Multimodal concepts with surgery and chemotherapy
  • Multimodal concepts with radiotherapy and chemotherapy
  • Multimodal concepts with radiotherapy and immunotherapy
  • Combined treatment approaches with chemotherapy and immunotherapy
  • Systemic treatment with molecularbiological stratified therapy
  • Systemic treatment with chemotherapy
  • Systemic treatment with immunotherapy
  • Systemic treatment with stereotactic radiotherapy
  • Systemic treatment with IMRT (intensity modulated radiotherapy)
Prof. Dr. med. Claus Peter Heußel

Head of Department (Diagnostische und Interventionelle Radiologie mit Nuklearmedizin)

Diagnostic and Interventional Radiology including Nuclear Medicine 

The Department of Diagnostic and Interventional Radiology with Nuclear Medicine offers both diagnostic and therapeutic services: Images of the thoracic organs, bones, and vessels are produced in various techniques, using multislice computed tomography, including dynamic CT, nuclear imaging incl. PET, ultrasound of abdominal and thoracic organs, including color doppler flow evaluation, and multichannel magnetic resonance imaging (MRI) using a comfortable 70 cm wide bore system. There is a huge experience and routine in taking tissue biopsies by image guidance CT or ultrasound), placing catheters or drainage systems. Furthermore, lung tumor lesions or metastases are ablated  by experienced interventional radiologists using e.g. radio frequency probes (RFA).   

Our modern equipment is state-of-the-art in imaging technology ensuring efficient and low-radiation investigation, or even without radiation. All devices are connected to a radiological image network and digitally stored in original quality in a dedicated Picture Archiving and Communication System (PACS). Findings are evaluated on high resolution screens by leading dedicated chest radiologists. Versatile image post-processing software allows further processing of the resulting images for, among others, 3D presentation, or quantifying emphysema.  

For evaluation of your records by Thoraxklinik experts, please send your radiological data in DICOM format on a CD ROM. All radiographic findings from examinations in our clinic will be handed over to you on CD ROM. 

The Department of Diagnostic and Interventional Radiology with Nuclear Medicine provides a wide spectrum of diagnostic and interventional techniques, the most up-to-date imaging techniques and numerous apparatuses. These include:

  • Multilayer computed tomography (CT, MS-CT)
  • Magnetic resonance imaging (MR, MRI, NMR, magnetic resonance imaging)
  • Interventional radiology (biopsy, tumor ablation)
  • Projection radiography (conventional x-ray) and fluoroscopy
  • Sonography (ultrasound, Doppler / Duplex)
  • Nuclear medicine (scintigraphy)

Computed Tomography

  • Dynamic CT of the airways for collapse diagnostics
  • High-definition CT for diagnosis of lung tissue conditions
  • CT-guided biopsy and tumor ablation
  • Vascular imaging (angio-CT) of the head, neck and thorax and abdominal region
  • Multiphase CT for tumor diagnostics
  • Bone density measurement
  • Preoperative and preinterventional diagnostics in the course of navigation, in collaboration with the Department of Interventional Pneumonology and Thoracic Surgery

Magnetic Resonance Imaging

  • MRI of the lungs (particularly for radiation-sensitive young patients and expectant mothers or for frequently repeated examinations)
  • MRI of the pulmonary circulation (perfusion)
  • Contrast medium-free imaging of pulmonary embolisms
  • MRI of the airways (trachea, airways collapse) during free respiration
  • MRI of the diaphragmatic movement during free respiration
  • MRI of the heart and flow measurement, e.g. for pulmonary shunts, arteriovenous malformation (AVM), displaced pulmonary vein outlet, pulmonary hypertension
  • MRI of the breastbone (sternum)
  • MRI of the paranasal sinuses
  • Whole-body MRI (orienting examination)
  • MR angiography (vascular imaging: arteries and veins of the head and neck, chest and abdominal cavity, pelvis and legs)
  • MR cholangiopancreatography (MRCP, imaging of the biliary tract and pancreatic ducts)
  • Diffusion MRI (acute cerebrovascular accident and tumor diagnostics) Biopsy and interventional color Duplex sonography
  • Areas of application are conditions of the abdominal, the thoracic wall, of the soft tissues, the neck, the lymph nodes and include the thyroid gland

Nuclear Medicine

  • Skeletal and lung scintigraphy
Priv.-Doz. Dr. med. Werner Schmidt

Head of Department (Anästhesiologie und Intensivmedizin)

Anaesthesiology, Intensive Care, Pain Therapy

Major thoracic surgical interventions are performed exclusively with the application of general anaesthesia. In Thoraxklinik Heidelberg, this type of anaesthesia is also used with smaller diagnostic procedures, e.g. bronchoscopy or the implantation of port catheter systems to avoid impairment of the patients’ well-being as far as possible.

Patients are monitored at the ICU both after major surgical interventions and for severe acute or chronic conditions, in close cooperation with the respective medical disciplines involved. Consequently, a focal point in our range of services is the weaning of long-term ventilated patients.  

Each patient receives intensive postoperative pain management. Pain therapists from Anaesthesiology may also be requested to assist cancer patients with pain problems. 

Anesthesiology:

  • Perioperative care of patients before, during and after diagnostic and surgical procedures
  • Application of state-of-the-art and innovative anesthetic and monitoring techniques

Intensive care medicine:

  • Care of patients following major surgical procedures
  • Monitoring and treatment of all critically ill patients in the hospital
  • Care of weaning patients during withdrawal of long-term ventilation
  • Focus: Treatment of critically ill patients with acute / chronic lung failure (ARDS / COPD / ILD patients, etc.)
  • Application of lung substitution techniques (ECMO)

Emergency medicine:

  • Care of all hospital emergencies

Pain therapy:

  • Postoperative Acute Pain Service
  • Application of advanced systemic and regional pain therapy techniques
  • Pain therapy consultation for patients with pain problems
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