Thoracic Program

Thoracic Surgery at Hackensack Meridian Health Mountainside Medical Center

Thoracic surgery encompasses the diagnosis, management and treatment of lung cancer and other chest diseases, including mesothelioma, chest wall growths or congenital abnormalities, mediastinal tumors, esophageal cancer, esophageal motility issues and metastatic tumors to the chest region. The Thoracic Surgery Service provides a multidisciplinary team approach that works closely with specialists in pulmonary medicine, oncology, gastroenterology, and wide-ranging support services. Our Service interacts closely with the Lung Cancer Screening Program sponsored by Mountainside Medical Center Medical Center, as well as the Thoracic Surgical Program at Hackensack University Medical Center.

The Division of Thoracic Surgery is directed by Steven D. Herman, M.D., FACS, and an internationally recognized thoracic surgeon.

Our Team

From left to right: Cinnamon Ballard, Medical Secretary, Valentina Kokler, P.A., Steven Herman, M.D., FACS, Susana Berezkin, R.N.

Experienced Thoracic Oncology Service in NJ

Technology, skill, and experience

The Thoracic Surgical Service at Hackensack Meridian Health Mountainside Medical Center has access to the most advanced instrumentation and innovative approaches for the treatment of tumors of the chest. In addition, patients diagnosed with advanced tumors that elsewhere are often considered untreatable or inoperable often find hope with us. Many of these patients maintain or regain quality of life for extended periods; some permanently. Although surgical removal oftentimes offers the best opportunity for cure, occasionally, the solution will be a combination of other treatment modalities, sometimes with innovative surgical solutions. Our extensive experience also makes us uniquely qualified to manage less common conditions such as carcinoid and interstitial lung diseases. As your partner on this journey, we are here to help you achieve your best possible outcome.

Meet Our Thoracic Surgeons

The Thoracic Surgery Division at Mountainside Medical Center is comprised of three board certified surgeons, practicing independently, who are part of the nation's top ranked hospital networks in New Jersey. The surgeons on our team have decades of experience in diagnosing and treating thoracic conditions including cancers of the lung, airway, mediastinum, and esophagus, as well as non-cancerous thoracic diseases.

Steven D. Herman, MD, FACS

Dr. Herman is Chief of Thoracic Surgery at Hackensack Meridian Health Mountainside Medical Center and is a pioneer in the development of minimally invasive treatment of thoracic conditions. He is among one of the first surgeons to perform minimally invasive thoracic surgery and he performed the first VATS lobectomy in the Greater New York area. He is ranked as one of the national leaders in outcomes for this procedure and is recognized for managing the most complex thoracic surgical cases. Dr. Herman has a number of publications detailing innovative techniques and protocols for treating cancer, enhancing patient recovery and reducing length of stay after cardiothoracic surgery. These have been adopted by other institutions and he has lectured nationally and internationally on these topics.

Additionally he holds the title of Clinical Associate Professor at both Icahn School of Medicine at Mount Sinai Medical Center and at SUNY Downstate Medical School in New York. Prior to joining Hackensack Meridian Health Mountainside Medical Center, he served as Chief, Thoracic Surgery, SUNY-Downstate LICH, as well as Senior Attending Surgeon at Mount Sinai Medical Center. A graduate of Johns Hopkins University School of Medicine, he completed residency training in both general and cardiothoracic surgery at New York Hospital-Cornell Medical Center and Memorial Sloan-Kettering Cancer Center. Dr. Herman is certified by the American Board of Thoracic Surgery and has been listed in the New York Times Superdoctor listings of the best physicians in New York.

Bruce S. Goldenberg, M.D.

Dr. Goldenberg received his medical degree at Northwestern University and completed training in general surgery and cardiothoracic surgery at New York University Medical Center. Dr. Goldenberg is board-certified in Thoracic Surgery. He specializes in heart and lung procedures, including resection of lung tumors, bypass surgery and pacemaker implantations. Dr. Goldenberg maintains an individualized treatment approach, ensuring that all recommendations are tailored for each patient's individual needs, including surgical and non-surgical treatment plans, or a combination of both.

Dr. Goldbengen is a Fellow of the American College of Surgeons, and is a member of the National Society of Thoracic Surgeons. He has served as the president of the New Jersey Society of Thoracic Surgeons, and has been recognized as a Top Doctor in the New York area for over ten years.

Godfrey C. Pinder, M.D.

Dr. Pinder received his medical degree at the Medical College of Wisconsin. He completed his internship a surgical residency at Tufts University, and went on to complete a thoracic surgery residency and fellowship at Temple University. Specializing in cardiovascular disease, Dr. Pinder is board-certified in cardiovascular surgery and thoracic surgery.

Why Choose Mountainside Medical Center

The Thoracic Surgery Service at Mountainside Medical Center aims to improve patient care and patients' outcomes. Our approach is simple: timely, high quality care with an emphasis on you. Recent medical research (Damico, 2017) has documented that a short time interval from diagnosis to definitive treatment is critical to achieving the best cancer cure results. We understand patients diagnosed with lung cancer and other chest disorders often face complex, time-consuming testing to define the status of their disease (staging). These evaluations are essential to choosing the ideal treatment plan for the individual patient. Our team has formulated an efficient pathway—from initial consultations, necessary testing, medical clearances, directly to treatment, whether surgery or other option—in a time frame that optimizes your chances for a cure.

State-of-art Care, Close to Home

Minimally Invasive

At Mountainside Medical Center, we are continuing to use innovative technology in new and exciting ways. Our surgical team has been active in VATS surgery since its inception, and has played a role in its development and instrumentation. With a minimally invasive Video-Assisted Thoracoscopic Surgery (VATS) approach, surgery is performed through a one inch incision guided by a tiny camera, inserted through a second small incision on the patients' side. Magnified images are projected onto a monitor and specially designed instruments are inserted to treat affected areas. VATS minimally invasive surgery is the method of choice at Mountainside Medical Center. This means smaller chest incision, shorter hospital stays, less postoperative pain, and a more rapid return to a normal life.

ON-Q* Pain Relief System, Limiting opioids

It has also been noted in enhanced recovery protocols involving surgery of different types that patients given significant opioid pain relief in the hospital recover slower and have increased length of stay. We at Mountainside Medical Center have designed a protocol that significantly limits and in some cases eliminates opioid postoperative medications. Utilizing ongoing infusions of numbing medications directly onto the nerves near the incision, patients experience significant pain relief without the need for epidural spinal catheters and without the negative producing side effects of opioids. Patients are mobile from the outset of their recovery from major thoracic surgery. This is utilized in both open and minimally invasive surgery. Mountainside Medical Center is one of the only hospitals, in the area, offering this unique alternative to standard pain control.

Tumor marker analysis, custom tailored therapy

We take great pride in offering tumor biomarker analysis to all of our oncology patients. Each tumor is examined to assess the unique molecular biology to help oncologists personalize cancer therapy. Mutations are defined to steer treatment recommendations. By comparing the tumors biomarkers with data from clinical studies from thousands of the world's leading cancer researchers, we provide oncologists information about which chemotherapy and/or other treatments are likely to be most effective and which treatments are likely to be ineffective for each patient – enabling the delivery of precision medicine. This comes at no cost to you.

We are a Cancer Center

Mountainside Medical Center is recognized by American College of Surgeons Designated Cancer Center. As such, it meets stringent standards in the management of all cancers. Its cancer program is reviewed regularly and subject to strict evaluation by the American College of Surgeons, which oversees much of cancer care throughout the United States. We value our ability to access a full range of expert physician opinions in the form of Tumor Board. Here, we are able to review your individual case & collaborate with an elite committee of multidisciplinary specialists. We are proud of this prestigious designation and what it means: Cancer Care Second to None.

A Life-long Journey

Your journey with us does not stop at surgery. We perform ongoing surveillance on all our patients. We are Here, Every Step of the Way.

Lung Cancer Diagnosis & Treatment

Lung cancer is one of the most commonly diagnosed cancers. It is the most deadly cancer encountered but treatments, if applied early and appropriately, can be life-saving. It can happen to anyone at any time, even non-smokers.

Types of Lung Cancer

There are two main varieties of lung cancer, depending from which cells the cancer originates. Non-small cell lung cancer (NSCLS) is the most common type. Its treatment frequently involves surgery, which brings the best outcomes. Small Cell Lung Cancer (SCLC), on the other hand, tends to grow and spread quickly. The primary treatment for SCLC is often chemotherapy.

Staging is Key

Treatment for lung cancer varies depending on a variety of factors, including the type of lung cancer and most importantly the stage of disease. Has it spread outside the lung to other organs? Are lymph nodes involved? How large is it? Once staged, a treatment plan that may consist of surgery, chemotherapy, targeted cancer therapy or radiation (traditional or novel approaches) is created for the patient. On occasion, combination therapy, utilizing multiple modalities is required for optimal treatment.

Non-Invasive Diagnostic and Staging Procedures

Radiologic and Nuclear Medicine Scans: CT scan of the chest is usually done to investigate an abnormality, symptom, or other reason and frequently is the basis of referral to a thoracic specialist. Additional radiologic studies are frequently performed to assess if an abnormality is tumor as well as, to determine the extent of the process. Some imaging that may be necessary include PET CT, MRI, CT scan and bone scan which are non-invasive.

Bronchoscopy: Performed by either a pulmonary specialty physician or thoracic surgeon. It is an examination of the trachea and bronchi (tubes leading to the lung) utilizing a camera which is passed into the airway by a flexible tube. It can be done either under local numbing analgesia or general anesthesia. Patients most often can go home the same day and hospitalization is not necessary. Samples of tissue can be obtained to make a diagnosis of a lung abnormality.

Endobronchial ultrasound (EBUS): Samples lymph glands in the chest to diagnose cancer, infections or diseases such as sarcoidosis. EBUS is performed through a bronchoscope and therefore requires no surgical incision. Ultrasound identifies target lymph nodes and allows biopsies to be done under direct ultrasound guidance.

Navigational Bronchoscopy: An innovative technology combining bronchoscopy, CT scanning and GPS concepts, allows tissue sampling of growths in the lung. This can obtain diagnostic tissue from hard to reach peripheral lung nodules or masses and is an alternative to CT guided biopsy, which involves using an invasive needle to enter the chest to biopsy a lung lesion. Navigational bronchoscopy does not require hospitalization.

Invasive Diagnostic and Staging Procedures

CT Guided Lung Biopsy: Performed by an experienced thoracic interventional radiologist. The lung lesion is accessed by a needle placed through the chest, under local anesthesia. Patients typically go home the same day and hospitalization is not necessary.

Mediastinoscopy: This procedure accesses and samples lymph nodes adjacent to the trachea, and stages the tumor by clarifying whether nodes have cancer. It is a surgical procedure under general anesthesia, with a small incision in the lower neck. Patients typically go home the same day with no hospitalization necessary.

Surgical Procedures

Lobectomy: This definitive procedure is considered the gold standard of care for lung cancer and involves removal of the lung lobe containing the tumor. Lobectomy, when feasible, has been the treatment of choice for early stage lung cancer for over 60 years and multiple medical studies have reconfirmed this is the best option for cure. This procedure has traditionally been performed via an open surgical approach. It can also be performed by minimally invasive VATS technique (Video Assisted Thoracic Surgery) although this is a more complex and technically challenging procedure. Our extensive experience with VATS technique permits safe and effective results. We offer methods that facilitate complete tumor removal, while preserving lung function and offering shorter recovery time.

Our goal is to provide the results of our evaluation in a timely manner. Less Stress and Better Outcomes.

 

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Conditions Managed

  • Malignant Lung Conditions
  • Lung nodules/nodes
  • Lung Cancer
  • Mediastinal tumors
  • Mesothelioma
  • Carcinoid Tumors
  • Thymoma
  • Lung Cancer Screening

Non-Cancer Lung Conditions:

  • Pleural Disease
  • Interstitial Lung Disease

Esophageal Conditions:

  • Benign Esophageal Disease
  • Achalasia
  • Esophageal Cancer

Other Conditions We Treat:

  • Chest Wall Disorders (pectus excavatum)
  • Hyperhidrosis (Excessive Sweating)
  • Pleural Effusions
  • Pneumothorax

Procedures performed

Lung Cancer Procedures:

  • Lung Cancer Resection
  • VATS / Robotic/ Open Lobectomy
  • VATS Wedge resection
  • Pneumonectomy
  • Segmentectomy
  • Pulmonary Sleeve Resection
  • Lung Biopsy
  • EBUS
  • Navigational/Super D Bronchoscopy
  • Mediastinoscopy
  • Endobronchial Tumor Resection
  • Airway Stenting

Other Procedures We Perform:

  • Esophageal Resection
  • Esophageal Myotomy
  • Thymectomy
  • VATS Sympathectomy

 

To learn more about our Lung Cancer/Lung Nodule Program or to schedule an appointment, please visit www.mountainsidehosp.com/lung