Lenox Hill Thoracic Surgery
National Leaders in Minimally Invasive Thoracic Surgery
Richard Lazzaro, MD FACS
Byron Patton, MD

Our Team

Richard S. Lazzaro, M.D.

Byron Patton, M.D.

Chief, Division General Thoracic Surgery

Director, Thoracic Oncology Tumor Board 

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 graduated from the six year biomedical education program at the Union University, graduating from the Albany Medical College in 1988. Dr. Lazzaro completed his general surgical residency at the North Shore University Hospital/Cornell University in 1994, including a surgical research fellowship in heart transplantation. Dr. Lazzaro then went on to study cardiac surgery under the direction of renowned surgeon, Dr. Joseph Cunningham, at the State University of New York. Following this, Dr. Lazzaro attended the University of Pittsburgh Medical Center for an advanced minimally invasive fellowship in thoracic surgery, under the direction of Dr. James Luketich. Dr. Lazzaro returned to his home, New York City, where he had been in practice from 1998 through June, 2012, performing minimally invasive robotic surgery for the benefit of his patients, his community, attaining the position of division chief, general thoracic surgery at the NYMH, a member of New York-Presbyterian Healthcare System, affiliated with Weill Cornell Medical College.

For his excellence and efforts in the field of robotic thoracic surgery, Dr. Lazzaro was awarded the Northeast Epicenter for robotic thoracic surgery. Presently, Dr. Lazzaro has moved to the Lenox Hill Hospital, North Shore LIJ Health System, as Chief of the division of General Thoracic Surgery and head of the Northeast Epicenter for Robotic Thoracic Surgery.

Dr. Lazzaro is a board certified Cardiothoracic as well as General Surgeon specializing in minimally invasive surgery since 1997. He has over 23 years of experience in surgery and is now performing the majority of procedures utilizing the daVinci robotic system. Accomplishments include performing the first complete robotic pneumonectomy in the NYC area as well as pulmonary lobectomy for pulmonary sequestration, which has been rarely accomplished in adults, less than a handful of cases reported in the United States. He brings advanced robotic techniques to not only serve the residents of the tristate region, but also to train surgeons from across the country.

Minimally invasive surgery has been shown to have similar if not better outcomes than traditional open surgery, in addition to shorter stays in the the hospital, less inflammation and blood loss as well as better preservation of the immune response to surgery, which may contribute to the improved 5 year survival being reported with minimally invasive surgery for cancer treatment. The application of the robotic instrument to minimally invasive surgery allows Dr. Lazzaro to greatly enhance the visualization and magnify the anatomy so that a more precise surgery can be performed by him.
Dr. Patton trained in general surgery at the Beth Israel Medical Center in New York City.  After completing his general surgery residency, he attended the University of Pittsburgh Medical Center for a specialized residency training program in cardiothoracic surgery.   University of Pittsburgh Medical Center cardiothoracic surgery department is widely regarded as one of the best training centers for minimally invasive thoracic surgery.  After successfully completing his residency in cardiothoracic surgery at UPMC, Dr. Patton did an advanced fellowship at Cornell Medical Center in New York City under the direction of Dr. Nasser Al Torquay.  This fellowship comprised a 12 month comprehensive program dedicated to video assisted thoracic surgery, with a focus on lung cancer surgery, sub- lobar resection, VATS lobectomy, as well as minimally invasive esophageal surgery for benign and malignant disease of the esophagus.

​Following completion of his advanced fellowship in minimally invasive thoracic surgery, Dr. Patton joined our team in July 2016.  He quickly rose to the director of the thoracic oncology tumor board, and has already developed a successful practice.  He works as an integral team member with Dr. Lazzaro.  Together, they have attained three-star certification from the Society of thoracic surgery in regards to lung cancer surgery outcomes, significantly better than the national average.  Only 10 programs have achieved this recognition across the United States.  We are proud to have been selected for the third consecutive time to have been given this honor, and look forward to developing our program further in order to take care of our patients the best.

Northeast Robotic Thoracic Surgery Epicenter

Dr. Richard Lazzaro and his program was named a Center of Excellence Epicenter for Robotic Thoracic Surgery, being recognized as a leader in the field of robotic thoracic surgery and demonstrating "best practice" ; 1st in the Northeast and 3rd in the United States.  Surgeons frequently travel to New York to learn robotic thoracic surgery from Dr.Lazzaro and his team. 

The daVinci surgical system, a robotic modality, is now a powerful tool in 10 surgical specialties and over 140 procedures. The da Vinci robotic system provides stereoscopic three-dimensional vision, enhanced dexterity and enables the surgeon to operate through small keyhole incisions, providing surgical technique with increased precision as compared to laparoscopic open surgery.

We are very pleased that we have been able to introduce robotic-assisted surgery for performance of minimally invasive major thoracic procedures, including lobectomy, pneumonectomy, thymectomy, esophagectomy, laparoscopic Heller myotomy for achalasia, laparaoscopic repair of paraesophageal hernia, and other lesser procedures such as intra-thoracic biopsies and pleural surgery.

Richard Stephen Lazzaro, M.D., Chief of Thoracic Surgery at Lenox Hill Hospital, a board-certified thoracic surgeon and board-certified general surgeon, who has performed over 3000 minimally invasive procedures, performs these operations. Dr. Lazzaro received his training for these procedures at the University of Pittsburgh Medical Center under James Luketich, M.D, a pioneer in this field in 1997. He currently performs the majority of his procedures, using the da Vinci robotic system, rendering superior clinical outcomes and shorter length of stay for patients. Dr. Lazzaro is also instructing other surgeons, who travel to our Hospital from throughout the United States to observe and learn robotic thoracic surgery.

Minimally invasive surgery has been associated with decreased bleeding, decreased need for blood transfusions and decreased cytokine release, leading to a 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 addition, patients experience less pain, a shorter length of stay and earlier return to their normal activities of daily living. Patients are more likely to complete adjuvant therapy after minimally invasive surgery, than with open surgery. Furthermore, the literature reports an improved five-year survival rate associated with minimally invasive lobectomy, over open lobectomy, for non-small cell carcinoma.

Dr. Lazzaro performed the first da Vinci robotic pneumonectomy in the five boroughs and one of the first da Vinci VATS lobectomies for intralobar pulmonary sequestration in the United States. Additionally, he performed a total robotic esophagectomy for an anemic patient with esophageal cancer, who would not agree to blood transfusion due to religious preferences.

We will be initiating educational initiatives across the New York Metro area to increase awareness of the surgical practice as well as the Epicenter launch. We look forward to the opportunity to partner with you. Please feel free to contact him directly at 212-434-3000 or via email if he can be of any assistance.

First Robotic Assisted Pneumonectomy in New York

Richard Lazzaro, M.D., chief of thoracic surgery at Lenox Hill Hospital, recently performed the first-ever robotic assisted pulmonary pneumonectomy in New York City. A pneumonectomy is most often used to treat lung cancer when less radical surgery cannot achieve satisfactory results. The procedure involves the removal of the lung that contains the cancerous legion. “Ninety-six percent of pulmonary lobectomy procedures are still performed through open incisions,” said Dr. Lazzaro. “Recent studies have shown that lung cancer patients treated with MITS have a better chance at long-term survival than patients who have undergone open surgery.”

The robotic surgical system has enabled thoracic surgeons to expand options for minimally invasive thoracic procedures. “Lenox Hill Hospital is part of an elite group of hospitals that offer minimally invasive thoracic surgery (MITS), said Dr, Lazzaro. “What sets us apart from other hospitals is that approximately ninety percent of my patients are treated using minimally invasive techniques.”

The robotic da Vinci® Surgical System offers surgeons both three dimensional visualization of the chest area and more flexible instrumentation. Just as with video assisted thoracic surgery (VATS)–another minimally invasive thoracic procedure offered at Lenox Hill Hospital–robotic surgery gives the surgeon access to the chest cavity through tiny incisions. Until recently, surgery to remove either part of the lung or the entire lung involved cutting into one side of the chest. However, this procedure would often result in significant acute and chronic pain, as well as a long recovery.

“By dramatically enhancing visualization, precision, control and dexterity, the robot overcomes the limitations of traditional thoracoscopic technology, helping physicians to perform complex surgery in new ways,” said Dr. Lazzaro. Because there are only a few small incisions, patients usually realize a number of benefits that include shorter hospital stays, less pain, quicker recoveries, reduced chance of infection, and decreased blood loss.

Dr. Lazzaro performs over 200 minimally invasive thoracic procedures per year. In addition to Robotic VATS, he performs a variety of minimally invasive robotic procedures including pulmonary wedge resection, pulmonary lobectomy, Heller myotomy, esophageal surgery, mediastial tumor resection, pleural decortication, Nissen fundoplication, and thymectomy.

General Thoracic Surgery

The practice of thoracic surgery is dedicated to treating patients whose conditions necessitate surgery of the lung, esophagus, chest wall, diaphragm or other structures within the chest. Dr. Richard Lazzaro, Chief of Thoracic Surgery at Lenox Hill Hospital, is dual board certified in thoracic surgery and general surgery. Dr. Lazzaro completed residencies in general surgery and cardiothoracic surgery as well as a fellowship in general thoracic surgery at SUNY/Downstate. He also completed a fellowship in minimally invasive thoracic surgery at the University of Pittsburgh Medical Center. He specializes in minimally invasive thoracic surgery, also known as VATS (video assisted thoracic surgery) or thoracocscopy, and utilizes the new robotic da Vinci® Surgical System.

The da Vinci® Surgical System dramatically enhances visualization, precision, control and dexterity, enabling physicians to perform complex surgery in new, minimally invasive ways. Procedures once performed using large open incisions are now done with tiny ones, making recovery quicker and less painful. Blood loss is minimized and the risk of infection is reduced. While laparoscopic and other minimally invasive techniques have been used for several years, the robotic assisted procedures allow for a new level of precision.

Lung cancer, which is the second most diagnosed cancer in men and women (after prostate and breast), is the number one cause of cancer death. It is generally diagnosed in older individuals. Patients, who have lung cancer are treated by a team of physicians. “There is never just a single pair of eyes looking at the patient,” said Dr. Lazzaro. “We use a multidisciplinary approach, working together to determine the best and most appropriate treatment for each patient.” “When surgery is required, we are able to offer our patients a better alternative – a minimally invasive surgery with results equal to an open procedure, but with a quicker recovery, and fewer complications.”

“As the population ages, there is an increased need for techniques that are well-tolerated among the elderly,” explained Dr. Lazzaro. Minimally invasive techniques, for a variety of reasons, are much easier for seniors to tolerate, and outcomes are often much better. The robotic, video-assisted thoracic surgery performed by Dr. Lazzaro requires just several small incisions, keeping blood loss to a minimum.

Procedures once performed using large open incisions are now done with tiny ones, making recovery quicker and less painful. Blood loss is minimized and the risk of infection is reduced. While laparoscopic and other minimally invasive techniques have been used for several years, the robotic assisted procedures allow for a new level of precision. Lenox Hill Hospital is one of an elite group of hospitals to offer minimally invasive thoracic surgery,” said Dr. Lazzaro. “What sets us apart from other hospitals is that approximately 90 percent of our patients are treated using minimally invasive techniques.”

Traditional surgery in the chest cavity requires large open incisions and carries a significant risk of complications. The beauty of minimally invasive procedures is that they accomplish the same treatment goals with fewer and smaller incisions, so patients enjoy a quicker and less painful recovery, shorter hospital stays, reduced chance of infection and decreased blood loss. “Over ninety percent of these procedures are still performed through open incisions,” said Dr. Lazzaro. “New studies show that lung cancer patients treated with minimally invasive thoracic surgery have a better chance of long-term survival than patients who have undergone open surgery.” 

The Division of Thoracic Surgery also specializes in minimally invasive, robotic surgery of the esophagus (esophagectomy, laparoscopic Nissen fundoplication for hiatal hernia, laparoscopic Heller myotomy for achalasis) as well robotic thymectomy for myasthenia gravis and thymoma.

​Comprehensive Lung Cancer Care

Comprehensive Lung Cancer Care
CLCC offers the most advanced technologies within traditional therapies, such as radiation oncology, surgery and chemotherapy, as well as many new therapies and procedures, including: 

Interventional Pulmonology
Interventional pulmonology is a medical discipline that offers an alternative to traditional surgical techniques. Interventional pulmonologists are able to perform a variety of diagnostic, therapeutic and palliative procedures, including:
• Stenting and laser therapy -- for patients with lung cancer who experience complications associated with airway obstruction
• Endobronchial ultrasound -- a precise sono guided fine needle aspiration to stage lung cancer.
Lenox Hill houses one of the few interventional pulmonology programs in the tri-state area.

Robotic Thoracic Surgery

Surgery is often an option for cancer treatment. Lenox Hill Hospital is a leader in minimally invasive surgery techniques, including robotic-assisted thoracic surgery, as well as cardiac surgery. Depending on the specific treatment plan, and the amount of lung or other tissue that needs to be removed, traditional open surgery or a minimally invasive surgical technique can be utilized. The main types of surgery for lung cancer removal include:
• Wedge Resection or Segmentectomy – removal of only a small part of the lung. 
• Lobectomy -- removal of one of the lobes of the lung.
• Pneumonectomy – removal of the entire lung. 

Surgical advances are allowing a wider range of options, including minimally invasive surgeries for early cancers and surgeries that relieve cancer symptoms in the late stages of the disease.
• Robotic-Assisted Surgery – Using the da Vinci robotic surgical system, surgeons are able to have 3D visualization of the surgical area, more flexible instrumentation, and the ability to access the surgical site through tiny incisions rather than larger, more invasive openings.
• Thoracoscopy -- Also known as video-assisted thoracic surgery (VATS), thoracoscopy is a less-invasive technique that uses a thin tube containing a miniature camera and surgical instruments. 
• Laser Surgery -- Laser surgery allows surgeons to remove small amounts of lung tissue. Laser surgery may also be beneficial in treating cancers that have spread to, and are obstructing, the throat.
• Photodynamic Therapy -- Photodynamic therapy uses bronchoscopy and special laser light beams combined with a light- sensitive drug to kill cancer cells. 
• Cryosurgery -- Cryosurgery involves a probe chilled to below freezing to destroy the tumor cells on contact. 
• Electric Cauterization and Thermal Ablation -- Electric cauterization and thermal ablation use electricity to produce heat that destroys tissue.
• Radiofrequency Ablation (RFA) –RFA utilizes an x-ray–guided electrode that delivers destructive heat to cancerous tissues. RFA may benefit lung cancer patients who are not eligible for surgery, radiation, or chemotherapy. 

Radiation Oncology

Radiation Oncology offers Stereotactic Body Radiotherapy (SBRT), a new technique of delivering radiation therapy in a very focused and precise manner to the specific area of lung tumor while preserving the normal tissues around it.  SBRT allows radiation therapy delivery to lung tumors that could not be treated as precisely with conventional radiation therapy and that may be inoperable. The precision associated with SBRT helps reduce the dose of radiation to normal tissue around a tumor, thus minimizing side effects for patients.   The Department of Radiation Oncology is also equipped to deliver radiation therapy via the lumen of the airways, in a process known as endo-bronchial brachytherapy. This technology allows airways to maintain their patency and result in better breathing capacity.

​MIS - Minimally Invasive Surgery

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 withdecreased bleedingdecreased need for blood transfusionsdecreased cytokine release, leading todecreased stimulus to the inflammatory systemThis 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.