The Center for Thoracic Surgery at Care New England

Personalized Experience

The Center for Thoracic Surgery at Care New England provides each patient with a unique patient experience, one that is tailored to fit the needs of the patient in their local community. Our center provides expert and personalized diagnostic and treatment services to patients with diseases and disorders of the lung including lung cancer, collapsed lungs, pleural effusions, molecular profiling, and emphysematous diseases. We also treat patients with disorders of the ribs/sternum.

Contact Information

Brigham and Women's Thoracic Surgery Associates at Care New England
Ambulatory Services Pavilion, First Floor
455 Toll Gate Road
Warwick, RI  02886
P: (401) 736-1092

About Us

Our thoracic surgery team has office locations in Warwick, Providence, and Pawtucket. They are available to meet all of your thoracic needs from the basic to the most complex. Thanks to our clinical affiliation with Brigham and Women's Hospital in Boston, we can provide you with a team of thoracic specialists considered among the best in the region.

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Diseases and Conditions We Treat

  • Chest Wall Disease
  • Esophagus
  • Lung and Airway
  • Mediastinum
  • Mesothelioma

Diseases and disorders of the chest wall, or rib cage, as well as the sternum, can be related to injury or illness. Rib fractures, both acute and chronic, are common following injury to the chest. Although many broken ribs heal without surgery, our surgeons offer evaluation and treatment if needed, using rib plating, a pioneering technique for repairing broken ribs that can reduce pain and recovery time.

Benign Esophageal Disease

The surgeons at Brigham and Women’s Thoracic Surgery Associates at Care New England treat a variety of diseases and conditions, including:

  • Zenker's diverticulum - An outpouching in the back of the throat.
  • Achalasia - Disorder of the esophagus that includes difficulty with the lower part of your esophagus relaxing enough to let food/liquids pass through.
  • Hiatal Hernia -A condition where the stomach that normally sits below the diaphragm, moves up into the chest area.
GERD (Gastroesophageal Reflux Disease or "acid reflux")

Our services include a comprehensive evaluation and workup as indicated including, endoscopy, esophagus, pH testing, and manometry.

Malignant (Cancer) Esophageal Disease

Cancer of the esophagus occurs when normal cells in the esophagus change into abnormal cells that grow out of control. Early on in the process, patients may have no symptoms or might have trouble swallowing, weight loss, pain, or burning in the chest area. Many of these symptoms can be caused by other conditions that are not cancer. If you have any of these symptoms, please discuss them with your physician or nurse. Our team will provide assistance and coordination of care with early diagnosis and treatment including surgery, chemotherapy, and radiation.

Lung Nodules

A lung nodule, or pulmonary nodule, is a small round or oval-shaped growth in the lung tissue. There are two main types of lung nodules, malignant (cancerous) and benign (non-cancerous). Benign lung nodules have a wide variety of causes including, but not limited to, infections, inflammation, and lymph nodes. They are often diagnosed on chest x-ray and CT scans. Diagnosis, work-up, and treatment will be guided by your thoracic surgeon.

Pleural Effusions

Pleural effusions are often described as "water on the lungs." It is a build-up of fluid that can develop between the chest wall and the lung itself. Pleural fluid is normally produced by the body to lubricate the lining of the lung. Many medical conditions including pneumonia, congestive heart failure, and certain types of cancer can cause a pleural effusion. Treatment can include removing the fluid from the space (thoracentesis) and can also include surgical intervention and catheter placement. Management of a pleural effusion often depends on the etiology.

Benign Lung Conditions 
  • Infections
  • Lung abscesses
  • Empyema
  • Auto immune disorders
  • Lung fibrosis
Pre-Lung Transplant Evaluation

A lung transplant evaluation involves a complete, comprehensive, and detailed evaluation of a candidate’s medical and surgical history and involves several clinical tests and meetings with physicians and staff. We are happy to provide initial care and care coordination for patients and clinicians seeking information about the pre-transplant evaluation. Surgical procedures will take place at Brigham and Women’s Hospital in Boston

Brigham and Women’s Thoracic Surgery Associates at Care New England offers comprehensive testing and advanced treatment for patients with the mediastinal disease. The mediastinum is the area between the lungs, containing the heart, aorta, thymus gland, lymph nodes, esophagus, and the trachea. The mediastinum can be the site of cancerous and non-cancerous tumors, including lymphoma, germ cell tumors and teratomas, neurogenic tumors, thymoma, and thymic cancer. Sarcoidosis, a non-cancerous inflammatory disease, can also entail mediastinal lymph nodes.

Conditions in the mediastinum can be difficult to diagnose as the symptoms often resemble other diseases. Brigham and Women’s Thoracic Surgery Associates at Care New England’s team of thoracic surgeons have special training in the diagnosis and surgical management of mediastinal disease with the most progressive technology and resources available in order to provide the best quality care for patients. 

 

Mesothelioma is a cancer that is complex and difficult to treat, and it, unfortunately, usually carries an abject prognosis.

The disease affects the outer lining of organs within the body, including the lungs, heart, and stomach, and well as inner wall of the body. Exposure to certain substances, such as asbestos, is closely associated with this condition, and the disease may not take form or affect the body until many years after.

Treatment for mesothelioma patients involves a multi-disciplinary approach. Several healthcare experts will need to contribute to a personalized treatment plan. Treatment usually includes

  • Chemotherapy
  • Radiation
  • Surgery

Depending on the type of mesothelioma, the procedures will be performed in the chest or abdominal cavity.

Lung and Thoracic Surgery

Lung Cancer

More than 225,000 Americans are diagnosed with lung cancer each year. There were 920 Rhode Islanders diagnosed in 2020; a rate Senior couple riding bicycle in countryside significantly higher than the national average. Treatment depends on the type and stage of lung cancer and may include one or more treatments, including:

  • Surgery
    • Tumor biopsy
    • Resection of a tumor and tumor mestastsis
  • Chemotherapy
  • Radiation therapy
    • External beam radiation therapy
    • Stereotactic Body Radiation Therapy or focused beam therapy
  • Targeted drug therapy
    • Radiofrequency ablation
Personalized Genomic Care

New innovations in care and treatment using personalized genetic information are available, including:

  • Targeted mutation testing
  • Personalized immunotherapy

Thoracic Cancer Surgeries & Procedures

Our thoracic surgeons work closely with the oncologists, pulmonologists, and medical teams at CNE and are involved in the work-up and diagnosis of new pulmonary nodules and conditions in the chest. This includes the use of new technology and advanced endoscopic procedures, such as EBUS, to aid in diagnosis and offer less invasive options to conventional lung surgery.

WHAT IS ENDOBRONCHIAL ULTRASOUND (EBUS)?

Endobronchial ultrasound (EBUS) is a minimally invasive procedure that uses ultrasound and a bronchoscope to diagnose lung cancer, infections, and lesions in the lungs and airways. During EBUS, the surgeon is able to take tissue samples from the lungs and surrounding lymph nodes from inside the airway instead of having to perform surgery. EBUS is usually performed under moderate sedation or general anesthesia, and patients often go home the same day.

WHAT IS ELECTROMAGNETIC NAVIGATIONAL BRONCHOSCOPY (ENB)?

Electromagnetic navigational bronchoscopy (ENB) is a minimally invasive procedure that uses GPS-like navigation technology to create a 3-D map of the lungs and chest for obtaining tissue samples or targeting lung cancer treatment. It is used to access lesions (spots) in areas of the lungs that cannot be reached by traditional bronchoscopy. Using the 3-D map and a thin instrument through the bronchoscope, the surgeon can obtain precise tissue samples or insert radio fiducial markers to target radiation to lung tumors. This procedure may help find lung cancer at earlier stages. ENB is usually performed on an outpatient basis, so patients can go home the same day.

Thoracic Cancer

Common pathologies that surgeries are performed for are:

  • Chest Wall Cancer
  • Esophageal Cancer
  • Tumors of the Middle Thoracic Cavity
  • Lung Cancer
  • Lung Nodules
  • Lymphoma
  • Mesothelioma
  • Neurogenic Tumors
  • Thymoma and Thymic Cancer

Thoracic Cancer Procedures

The types of surgeries performed are:

  • Bronchoscopy – Lungs and airway can be viewed using a thin lube being snaked often through the mouth or nose
  • Mediastinoscopy- A scope is used to view the inside the chest after an incision is made
  • Wedge resection – Remove a tumor, along with surrounding tissue
  • Anatomical segmental resection – Removes a tumor, blood vessels, and a section of the lung
  • Lobectomy – Removing the lobe of a lung, along with lymph nodes
  • Pneumonectomy – Removing an entire lung, along with the lymph nodes
  • Video-assisted thoracoscopic surgery – Less invasive lobectomy procedure to treat early-stage lung cancer
  • Benign Lung Conditions

da Vinci Xi Robot System

Brigham and Women’s Thoracic Surgery Associates at Care New England use the daVinci Xi robot for a minimally invasive approach to thoracic surgery. The Xi Robot allows for the surgeon to perform surgery using state-of-the-art technology in order to see in 3-D while in high-definition. The surgeon can see better, have better angles, and be even more precise in their work.

Surgeries being performed by the thoracic surgery team include lobectomies and mediastinal surgeries.

Learn More

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Frequently Asked Questions

What is Thoracic Surgery?
 Thoracic surgery encompasses the operative and perioperative care of the patient with an acquired or congenital condition of the chest. Thoracic surgeons perform evaluations of the lungs, esophagus, and other organs in the chest. Thoracic surgeons operate on diseases that occur in the organs inside the chest, and in the bony structures and tissues that form the chest cavity. General thoracic surgeons treat lung cancer and diseases of the esophagus.
What services are offered?

In addition to the areas of Cardiology and Pulmonary Medicine, Care New England Has a clinical affiliation with Brigham and Women’s Hospital in Thoracic Surgery. The physicians at Brigham and Women’s Thoracic Surgery Associates at Care New England are affiliated with Brigham and Women’s Hospital in Boston, and they provide care to patients in Rhode Island at Kent Hospital and at their outpatient office in the Ambulatory Services Pavilion on the Kent Hospital campus.

The Brigham and Women’s Thoracic Surgery Associates at Care New England offers comprehensive testing and advanced treatment for patients with diseases and conditions of the lung and airway, from more routine conditions to rare and complex diseases. We treat chronic obstructive pulmonary disease (COPD), tracheomalacia and emphysema, empyema and pleural effusion, pneumothorax/collapsed lung, and also specialize in tracheal and bronchial disorders, benign or cancerous.

Brigham and Women’s Thoracic Surgery Associates offers:

  • Inpatient evaluations
  • Outpatient evaluations
  • Preoperative assessment
  • Diagnostic testing review
  • Second opinions for complex cases
  • Referral for associated conditions
What are the tests and procedures involved?

Through the Kent Hospital, Diagnostic Imaging Department chest x-rays and chest CAT scans are available. We also assist with the scheduling of:

  • PET CT scans
  • Pulmonary function tests
  • MRIs
  • Esophageal manometry
  • pH measurements (for our gastroesophageal reflux patients)
  • Cervical mediastinoscopy
  • Referral to our Lung Cancer Screening Program

Our Team

Ciaran McNamee, MD

Chief, Thoracic Surgery, Kent Hospital
Assistant Professor, Harvard Medical School Thoracic Surgery, Affiliated with Brigham and Women’s Hospital

Matthew J. Pommerening, MD, MS

Associate Surgeon, Division of Thoracic Surgery 
Clinical Instructor, Harvard Medical School Thoracic Surgery, Affiliated with Brigham and Women’s Hospital

Abby White, DO

Associate Surgeon in the Division of Thoracic Surgery
Assistant Professor of Surgery, Harvard Medical School, Affiliated with Brigham and Women’s Hospital

Kimberly Lamendola, PA

Thoracic Surgery Physician Assistant