Additional Novel Techniques
for Thoracic Track Residents

ENDOBRONCHIAL ULTRASOUND (EBUS)

At the University of Minnesota, EBUS is performed by thoracic surgeons. Since the acquisition of EBUS equipment in September of 2006, we have performed 88 EBUS, 80 of these with FNA. Our results on the accuracy of EBUS in comparison with traditional approaches (i.e. mediastinoscopy, VATS) will be published in 2008 following a presentation at the STS meeting. Currently, we are performing 1 or 2 EBUS per week. Fellows actively participate and learn how to perform EBUS, our data suggest that a learning curve of 10 to 20 cases is necessary, and this goal will be easily met during fellowship.

ENDOSCOPIC ULTRASOUND (EUS)

In October of 2007 we became credentialed to perform EUS for esophageal cancer and lung cancer staging. Surgeons perform EUS in only a handful of institutions in the United States, and this is a unique opportunity for thoracic surgery residents to become certified in EUS.

Esophageal and airway stenting

We perform the vast majority of esophageal and airway stents at this institution. Currently, we place approximately 35 to 40 esophageal stents and 10 to 15 airway stents per year and we have experienced a steady growth in referrals.  The Division of Thoracic and Foregut Surgery is planning a yearly regional stent course (to start in 2008) that will allow fellows to participate as instructors and will increase our profile as a referral institution for these procedures. 

Esophageal function testing

Thoracic surgery residents have the option to learn how to interpret esophageal manometry and 24-hour pH testing with impedance. Our division interprets approximately 100 studies per year, and we are keeping a prospective database to facilitate research. This is an attractive tool for the general thoracic surgeon who has an interest in benign foregut diseases. 

_{Normal manometry}

_Achalasia

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