Global Connection: Dr. Michael Harden and chest wall resection

The short but informative Global Connection conference today delivered on two fronts; big and small..

Big for the multidisciplinary surgeries like large locally invasive tumor resections that offer hope to patients that might otherwise be turned away.. Small for the minimally invasive techniques and nonintubated techniques that improve the lives of our patients – faster recoveries, less post-operative pain and shorter hospital stays..

In a previous post, we talked about the John Wayne principle and large surgical resections. We’ve talked about multi-disciplinary surgeries before, but during today’s presentation by Dr. Michael Harden of Australia, he presented several cases that highlighted the critical importance of large scale surgical resections for stage IIB and IIIA lung cancers.

Dr. Michael Harden is a cardiothoracic surgeon at the Royal North Shore Private Hospital in a suburb of Sydney, Australia.

During his lecture, on chest wall reconstruction for lung cancer, Dr. Harden presented several cases illustrating successful large scale resections. While each of the procedures was technically challenging due to the presence of very large, invasive tumors, these cases were complex for multiple reasons such as pre-operative radiation, morbid obesity and other serious co-morbidities.

In each of these cases, he highlighted the importance of multi-disciplinary involvement, from plastic surgery for free flap harvesting and revascularization, to cardiac surgery (for ECMO/ CPR) for resection of tumors involving the great vessels or spinal surgery for a case requiring an enbloc removal of a vertebral body for a very large paraglioma involving the lung, vertebra and rib – which was encroaching on the the spinal cord.

One of his more notable cases is mentioned below. This case illustrates the importance of innovation and consideration for patient’s quality of living as this surgical technique allowed this patient to return to his job as a truck driver. (Many of the more commonly used techniques to repair the sternum such as muscle flaps are not as conducive to this type of occupation which requires more than sitting behind the wheel.)

  • We have reached out to Dr. Harden for more information about his work.