Board certified in both surgery and cardiothoracic surgery, Dr. Lazzaro has over 23 years of surgical experience and has performed over 3000 minimally invasive procedures. Dr. Lazzaro is a leader in the field of robotic thoracic surgery and has trained surgeons throughout the United States in his techniques. A member of the STS, Society of Thoracic Surgeons, NYSTS (New York Society of Thoracic Surgeons), Dr. Lazzaro has received the distinctions of America's Top Surgeons, America's Top Doctors, New York Top Doctor, Best Doctors, and New York Best Doctors, and has been featured on Fox News, CNN, as well as local newspapers and magazines.

Lung cancer can be detected on routine chest xray (CXR), or cat scan (CT scan) in up to 25 % of patients. CT scan screening is being evaluated for early detection of lung cancer in high risk patients (current and former smokers, ages 55 to 74 with a smoking history of at least 30 pack years, as defined by the National Lung Screening Trial, NLST.

Symptoms may be related to the lung, surrounding structures, spread to other areas of the body (metastasis) or related to hormones produced by the lung cancer, which cause other syndromes (paraneoplastic syndromes). Cough, wheezing, hoarseness, hemoptysis (coughing blood), shortness of breath, chest pain, back pain, weakness, stroke, bone fracture, jaundice, hypertension, swelling, facial swelling (superior vena cava syndrome), mental status changes, eye changes (ptosis, miosis, anhydrosis - Horner's syndrome) as well as fatigue, depression and weight loss.

Robotic Thoracic Surgery
Robotic Pulmonary Lobectomy
Robotic Wedge Resection
Robotic Segmentectomy
Robotic Pneumonectomy
Robotic Lung Volume Reduction
Robotic Esophagectomy
Robotic Heller Myotomy
Robotic Nissen Fundoplication
Robotic Paraesophageal Hernia
Robotic Thymectomy
Robotic Bronchogenic Cyst
Robotic Esophageal Duplication Cyst
Robotic Esophageal Leiomyoma
Robotic Decortication

VATS Thoracic Surgery
VATS Pulmonary Lobectomy
VATS Wedge Resection
VATS Segmentectomy
VATS Pneumonectomy
VATS Lung Volume Reduction
VATS Esophagectomy
Laparoscopic Heller Myotomy
Laparoscopic Nissen Fundoplication
Laparoscopic Paraesophageal Hernia
Laparoscopic Esophageal Leiomyoma
VATS Thymectomy
VATS Bronchogenic Cyst
VATS Esophageal Duplication Cyst
VATS Decortication

Bronchoscopy
Esophagoscopy
Video Mediastinoscopy
Tracheal Surgery

Recognized as a national leader in robotic thoracic surgery, Dr. Lazzaro is routinely requested to train surgeons in his techniques of robotic surgery. In addition, Dr. Lazzaro's robotic thymectomy technique was recognized for its precision and outcomes; a video was produced, released globally and serves as the instructional video for robotic thymectomy.

Dr. Lazzaro specializes in minimally invasive robotic surgery for the treatment of benign and malignant disorders of the lungs, esophagus, stomach and mediastinum, including lung cancer, pulmonary nodules, esophagus cancer,thymoma, myasthenia gravis, hiatal hernia and swallowing diseases. Dr. Lazzaro specializes in evaluation of lung cancer symptoms, lung cancer staging as well as performs robotic lobectomy for lung cancer, VATS lobectomy for lung cancer, minimally invasive esophagectomy including robotic and laparoscopic esophagectomyfor esophageal cancer, robotic thymectomy for myasthenia gravis, as well as robotic Heller myotomy for achalasia and laparoscopic Nissen fundoplication for hiatal hernia.

Dr. Lazzaro, a board certified Thoracic surgeon and board certified general surgeon, has had extensive experience performing da Vinci robotic surgery at the New York Region, and has recently accepted the position of division chief, general thoracic surgery at Lenox Hill Hospital. He has performed several thousand minimally invasive procedures, including da Vinci robotic VATS lobectomy, VATS pneumonectomy, VATS thymectomy, minimally invasive esophagectomy, laparoscopic Heller myotomy for achalasia, laparoscopic repair of giant paraesophageal hernia as well as other procedures.

Dr. Lazzaro currently performs the majority of his procedures, utilizing the da Vinci robotic system. This has afforded him the opportunity to continue to provide his patients with the benefits of minimally invasive thoracic surgery, now utilizing the best instrument available to perform the surgeries. The da Vinci robotic system is a $2.5 million instrument, which provides stereoscopic three-dimensional vision and enhanced dexterity. In essence, he is now able to operate through small keyhole incisions, providing surgical technique in the exact precise manner as open surgery.

Minimally invasive surgery has been associated with

•decreased bleeding
•decreased need for blood transfusions
•decreased cytokine release, leading to
•decreased stimulus to the inflammatory system

This decreased stimulus to the inflammatory system occurs concomitantly with less suppression of the patient's native immune system as compared to open surgery. In fact, natural killer cell function has been demonstrated to be more well preserved with minimally invasive techniques than with open procedures. In addition, patients experience less pain, shorter length of stay and earlier return to their normal activities of daily living. Patients are more likely to complete adjuvant therapy, when indicated, after minimally invasive surgery, than with open surgery. Perhaps, the combination of these factors has led to be improved five year survival rates associated with minimally invasive vats lobectomy over open lobectomy, which is being reported in the literature for non-small cell carcinoma.

Dr. Lazzaro performed the first da Vinci VATS pneumonectomy in the five boroughs; one of the first da Vinci robotic lobectomy procedures for intralobar pulmonary sequestration with an aberrant arterial tributary (which is one of the earliest cases performed in the United States), in addition to total robotic, da Vinci esophagectomy for an anemic patient with esophageal cancer, who would not agree to blood transfusion due to religious preferences. This patient was able to leave the hospital on postoperative day nine with the same hematocrit. Dr. Lazzaro trained on the first da Vinci robotic system, approximately 10 years ago, and is now offering robotic surgery for all his patients, as well as teaching other surgeons, who have traveled from the Northeast to observe and learn robotic thoracic surgery.

Clinical Robotic Surgery Association
Robotic Repair of Giant Paraesophageal Hernia
September 28, 2012

American College of Surgeons
Presentation on Robotic Bronchoplasty for complex lung surgery
October 1, 2012

Eastern Cardiothoracic Surgical Society
Robotic Lung Surgery: Standardization and Complex Cases
October 4-5

Dr. Lazzaro presents at the global expert panel regarding master techniques in robotic mediastinal surgery.

Dr. Lazzaro joins Lenox Hill Hospital/North Shore - LIJ Health System as Chief, Division of General Thoracic Surgery.

Dr. Lazzaro is selected as one of New York Magazines Best Doctors 2012.

"America's Top Doctors is the national guide that identifies more than 6,500 top specialists throughout the U.S. in more than 60 medical specialties and subspecialties for the care and treatment of more than 1,700 diseases and medical conditions. These outstanding doctors represent the top 1% in the nation." Castle Connolly

Advances in robotic surgery and minimally invasive surgery facilitate bloodless surgery initiatives. Frequently possible, robotic surgery minimizes trauma, pain, and blood loss, often resulting in significantly quicker recovery.

Dr. Lazzaro's Robotic Thoracic Surgery program has been designated a Center of Excellence - Robotic Thoracic Surgery Epicenter - the 1st such center in the Northeast and only the 3rd National Epicenter . . .

Dr. Lazzaro performs the first totally robotic pulmonary pneumonectomy in the NYC region, as well as one of the first totally robotic pulmonary lobectomy procedures for a congenital disorder, which has only been accomplished a handful of times throughout the world adult population.

The da Vinci® Surgical System is one of the most incredible surgical breakthroughs we have seen in decades. This is truly remarkable technology which has allowed us to extend the benefits of the laparoscopic /thorascopic approach to more and more individuals with lung cancer as well as complex benign thoracic surgical problems. Our da Vinci Surgery patients are back on their feet and return to their normal activity much faster than those who undergo open thoracotomy incisions. Our results from robotic daVinci lobectomy have been excellent.

• Zero mortality.
• No major complications.

Typically patients have shorter hospital stays, faster recovery time, reduced pain, less need for narcotics, fewer side effects and less scaring and blood loss. The benefits of robotic-assisted minimally invasive surgery are immeasurable. Unlike standard laparoscopic/thorascopic surgery, the da Vinci system provides 3-D vision, and hand movements are translated to micro-instruments in the operative site making the procedures much easier, more precise and safer.

Procedures now performed with the da Vinci system include:

• Robotic pulmonary lobectomy
• Robotic pulmonary segmentectomy
• Robotic thymectomy
• Robotic anterior/posterior mediastinal resection
• Robotic esophageal surgery

Richard Stephen Lazzaro, M.D.
Chief, Thoracic Surgery
Lenox Hill Hospital