The Thoracic Surgery Service at Hospital Germans Trias i Pujol provides high-complexity healthcare to patients with thoracic pathology. It provides healthcare to a catchment population of over 800,000 inhabitants in North Barcelonès and the Maresme, and serves as a referral centre for certain conditions in an expanded area of up to 1,200,000 people. The service is part of the Clinical Directorate of the Thorax Area.

The mission of the Service is to provide comprehensive, high-quality care based on innovation and multidisciplinary collaboration, with a clear commitment to teaching and research. Its vision is to establish itself as a national and international reference centre, particularly in the field of minimally invasive and robotic thoracic surgery. The clinical activity includes oncological lung and mediastinal surgery, airway surgery, pleural, diaphragmatic and thoracic wall pathology, as well as the surgical treatment of emphysema and hyperhidrosis, with a clear commitment to advanced techniques.

Its clinicians teach at the Faculty of Medicine of the Autonomous University of Barcelona and are actively involved in continuing professional development.

The service:

• Collaborates with the Guttmann Institute on the Diaphragmatic Pacing Implantation programme, being accredited as a CSUR (Centres, Services and Units of Reference of the National Health System).
• Is an accredited centre by the European Society of Thoracic Surgeons (ESTS) for training in robotic thoracic surgery, and hosts national and international fellows.
• Is a founding and participating centre of GETORO (the SECT Robotic Thoracic Surgery Group).
• Furthermore, develops clinical and translational research projects in collaboration with the Germans Trias i Pujol Research Institute (IGTP) and the other institutions on the Can Ruti Campus, contributing to the continuous improvement of clinical practice in thoracic surgery.

Featured service news: 

• Hospital Germans Trias simplifies the management of lung lesions by diagnosing, marking and removing them in a single surgical procedure.
• We celebrate more than 600 major robotic thoracic surgery procedures at Hospital Germans Trias.

Pioneers in robotic thoracic surgery with intraoperative localisation using electromagnetic navigation:

The Thoracic Surgery Service at Hospital Germans Trias i Pujol is one of the pioneering centres in Spain in combining intraoperative bronchoscopic electromagnetic navigation (Illumisite™) with robotic-assisted surgery (Da Vinci Xi) for the diagnosis, marking and resection of pulmonary nodules in a single surgical procedure. This strategy allows for the precise localisation of small or deep lesions and avoids additional procedures such as ROLL or transthoracic needle aspiration.

High volume and expertise in robotic thoracic surgery:

The service has performed over 650 robotic thoracic surgeries since the programme began, with an annual volume now approaching 200 robotic thoracic procedures, placing it among the busiest centres for robotic thoracic surgery in Spain. All specialists are trained as console surgeons and the service has a structured robotic training programme, accredited by the European Society of Thoracic Surgeons (ESTS), welcoming national and international fellows.

National Reference Centre (CSUR) for the Diaphragmatic Pacemaker Implantation Programme:

Hospital Germans Trias i Pujol is the only centre accredited as a CSUR for the Diaphragmatic Pacemaker Implantation Programme, in collaboration with the Guttmann Institute. This programme offers comprehensive, highly specialised care to patients with diaphragmatic paralysis, combining surgical expertise, functional rehabilitation and multidisciplinary teamwork.

VAMLA as a procedure included in the service portfolio:

The Thoracic Surgery Service is one of the few centres in the country that routinely performs video-mediastinoscopy-assisted mediastinal lymphadenectomy (VAMLA), both for diagnostic purposes and for precise staging of lung cancer. This technique provides a high diagnostic yield and comprehensive mediastinal staging, which is key to correct therapeutic indication.

3D reconstruction and virtual surgical planning:

In clinical practice, the service uses three-dimensional reconstruction and virtual modelling for the preoperative planning of complex surgeries. This tool allows for a better individualised anatomical understanding, facilitates surgical decision-making, optimises the precision of resections (especially segmental ones) and contributes to improving surgical safety and outcomes.

The research activity of the Thoracic Surgery Service at Germans Trias i Pujol University Hospital is significant and sustained, with active participation in local, national and international research projects, as well as in high-impact multicentre clinical trials.

• A clinical trial has been conducted: Study NF001, EudraCT No. 2014-005062-30. A randomised, double-blind, placebo-controlled clinical trial to assess the functional status of the phrenic nerve after periphrenic lidocaine infiltration in lung resection surgery, with the service sponsor and principal investigator (PI) being Dr Martínez.
• More than 15 articles have been published in indexed specialist and related journals.
• A book chapter has been published: J. Pérez, C. Martínez-Barenys. Is the clipping method for sympathetic nerve surgery a reversible procedure? A Hyperhidrosis. A Complete Guide to Diagnosis and Management, Editors: M de Paula, Ribas M. de Campos, Wolosker, Kauffman. Springer Int. Publishing 2018. ISBN:978-3-319-89526-0.
• More than 30 scientific communications have been presented in the form of lectures, oral presentations and posters at national and international congresses in the field.
• Participation as collaborating researchers in the following multicentre research and study groups:

► Lung Biobank Platform (CIBERES), Carlos III Health Institute

► Spanish Lung Cancer Research Group (GECP)

► Spanish Pleural Mesothelioma Group (GEMEP), an integrated SEPAR Research Programme.

► Spanish Group of Robotic Thoracic Surgery (GETORO) of the Spanish Society of Thoracic Surgery (SECT).

► Spanish Group of Video-assisted Thoracic Surgery (GEVATS) of the Spanish Society of Thoracic Surgery (SECT).

► Participation in the Spanish Society of Thoracic Surgery Registry (ReSECT)

► Study D9108C00002 Phase 2 Open-label, Multicenter, Randomized, Multidrug Platform Study of Neoadjuvant Durvalumab Alone or in Combination with Novel Agents in Subjects with Resectable, Early-stage (I [> 2 cm] to IIIA) Non-small Cell Lung Cancer (NeoCOAST).

► Characterisation of the pathogenesis of the SARS-CoV-2 virus in lung tissue. (LUNGCOV). IrsiCaixa promoter.

► NADIM Neoadjuvant ‘Phase III clinical trial of adjuvant chemotherapy vs chemo-immunotherapy for stage IB-IIIA completely resected NSCLC patients’. Promoter: GECP.

► MK-3475-671 EC Phase III randomised, double-blind clinical trial. Neoadjuvant or adjuvant treatment with QT (CisPt doublet) ± Pembrolizumab in resectable stage IIB-IIIA NSCLC patients. Sponsor: Institut Català d'Oncologia (ICO).

► Member of the External Scientific Committee of the HUGTiP/IGTP Biobank. (Dr Martínez).

• Participation in national scientific societies:

► Dr Martínez: Member of the SEPAR Thoracic Surgery Area (2018-2020). Secretary of the Executive Committee of the SEPAR Thoracic Surgery Area (2022-2025)

► Dr Cladellas: Currently, Secretary of the Catalan Thoracic Surgery Society (SCCT)

Undergraduate teaching

The service has two Associate Professors in the Department of Surgery (Dr López de Castro and Dr Martínez Barenys). The remaining members of the team are Associate Professors in the Respiratory Pathology module. MIC II, 4th year of the UAB Medical Degree, and in the clinical placements for 3rd and 6th year medical students at UAB.

The service also teaches the Respiratory Pathology component of the Integrated Learning in Medicine (AIM) IV–UAB 4th year of Medicine course (Coordinator: Dr Martínez) and is accredited for specialist training in Thoracic Surgery via the MIR (Resident Tutor: Dr Cladellas Gutiérrez).

Postgraduate teaching

The service offers:

• Specialised Training in Thoracic Surgery (for Specialist Trainee Doctors)
• Visiting registrar rotations (national and international)
• On-site training in HUGTiP Robotic Surgery (Proctoring) for specialist trainees and specialists, national and international
• On-site training in diaphragmatic pacemaker implantation (proctoring)
• Accreditation training in Thoracic Robotic Surgery (Intuitive Accreditation) at the CMCiB and at accredited European referral centres

Residents information

• The service is accredited to provide one post for a Thoracic Surgery resident (MIR) every two years.
• Teaching guide.
• Find out what our residents think about the Thoracic Surgery service of the Germans Trias:

Continuous training

Organises an annual basic and advanced robotic thoracic surgery course for specialist thoracic surgery registrars.