Thorax and Vascular Surgery

Thoracic and Vascular Surgery Department consists of:

  • vascular surgery unit
  • thoracic surgery and oncological thoracic surgery unit

Our thoracic surgery and vascular surgery specialists provide the highest level of treatment in Estonia.

Vascular surgery unit

The vascular surgery unit is one of two in Estonia to provide higher level treatment. The department includes 14 vascular surgery beds providing 24-hour, year-round specialised supervision. Ambulatory admittance to the polyclinic takes place on four working days each week. Operations are conducted by our four clinically experienced vascular surgeons. The vascular surgery specialists cooperate closely with representatives of all others fields in the hospital; patients of vascular surgery are treated in cooperation with angioradiology doctors. The vascular surgery unit ensures reconstructive operations and endovascular procedures for all of Estonia.

Extensive clinical experience

We began conducting endovascular procedures in 1980 and we currently carry out more minimally invasive/endovascular operations than anyone else in Estonia. We are also the only facility in Estonia to provide thrombolysis treatment for clotting in limb arteries. Already in 2008, we became the first in Estonia to provide endovascular treatment of aortal aneurysms with stent prostheses. Annually, we conduct over 750 regular reconstructive operations as well as approximately 200 endovascular procedures on arteries in the operating room and in the angiography cabinet.

Each year, we provide ambulatory consulting to approximately 2,000 patients with various vascular surgical problems:

  • abdominal aorta and thoracic aorta expansion (aneurysms and dissections)
  • limb artery disorders (atherosclerosis, endarteritis, gangrene, embolia, thrombosis)
  • peripheral artery aneurysms
  • narrowing of the carotid, intestinal and kidney arteries
  • compression of tissues surrounding vessels (including thoracic aperture syndrome)
  • vascular trauma
  • vascular prosthesis infection

High quality study results

Our patient studies include both invasive (arteriography) as well as non-invasive methods (ultrasound, computed tomography, magnetic resonance tomography), which ensure high-quality results and patient satisfaction.

Wide selection of open and endovascular treatment methods

We use all traditional open and new endovascular treatment methods (and hybrid-operations), which aim to restore/preserve blood supply in various organs/tissues:

  • aortic aneurysm stent prosthesis
  • balloon dilatation and stenting of aortic branches
  • carotid artery endarterectomy and stenting
  • aortic bifurcation graft
  • bypass for limb arteries, using prosthesis or auto/alloveins
  • removal of thrombus or blood clot from the arteries (embolectomy, thrombectomy, endarterectomy)
  • arteriovenous fistula for patients with kidney deficiency
  • use of biological tissue (including donor tissue) in reconstructive operations for prosthesis infection
  • thrombolysis treatment for clotting in limb arteries

Thoracic surgery and oncological thoracic surgery unit

The thoracic and oncological thoracic surgery unit is one of two facilities in Estonia to provide services in this area. Approximately 1 million inhabitants live in our area of service. The department includes 14 vascular surgery beds and appointments with thoracic surgeons are available on every working day. Four thoracic surgeons work in the unit, together conducting over 400 operations and providing ambulatory consulting to 3,000 patients per year. Up to 40% of operations are conducted with endoscopic methods and that percentage continues to increase. All of the more complicated endoscopic procedures for diagnosing and treating tumours and trachea stenosis - endoscopic ultrasound as well as recanalisation of the respiratory ways and stenting - are conducted solely by the thoracic surgeons. Thoracic surgeons are on call 24 hours a day.

In the area of thoracic surgery, all of the modern diagnostic and treatment methods are utilised:

  • endoscopic diagnostics - endobronchial cryobiopsy and bronchoscopic ultrasound (EBUS), with 1,000 procedures carried out in five years, as well as the option of conducting a transesophageal ultrasound in the course of the same procedure (EUS)
  • mini-invasive surgery - VATS (thoracoscopic) lobectomy, VATS thymectomy for myasthenia and other more minor operations: lung resection, thoracic sympathectomy, decortication pleuraempyem, etc.
  • bronchoplasty operations preserving lung capacity for central lung cancer
  • expanded resection for malignant tumours of the lungs, mediastinum and thoracic wall
  • endobronchial valve insertion for emphysema patients
  • trachea stenosis stenting and surgical treatment
  • surgical treatment for thoracic wall deformation by endoscopic (in cooperation with Tallinn Children's Hospital surgeons) and open method

Thoracic surgeons participate in the work of the thoracic oncology council (directed by Dr Tõnu Vanakesa) and are members of the thoracic oncology interdisciplinary working group.

Important research projects and cooperation partners in the area of thoracic surgery

We participate in several international clinical studies, most notably MAGRIT and PEARL (see www.gsk-clinicalstudyregister.com/). These studies focus on personalised immunological treatment for operated patients of lung cancer, pertaining to the diagnosis of gene mutations MAGE-A3 and PRAME in the tissue of the tumour

Main cooperation partners

  • central and general hospitals in Tallinn and the counties
  • University of Tartu Clinic
  • Estonian Society of Thoracic Surgery
  • Estonian Respiratory Society
  • Estonian Society of Medical Oncologists
  • European Society of Thoracic Surgeons
  • European Association for Cardio-Thoracic Surgery
  • International Association for the Study of Lung Cancer