Minimally Invasive VATS Surgery Enables Local Lacrosse Player to Get Back to Play

As a varsity player for the Lacey Lions Lacrosse team, 17-year-old Forked River resident Zach Tripet is known for his fast shot, finesse and perseverance on the field. While at practice one day, Zach experienced chest pains and difficulty breathing. His coach convinced him to take a break. Later that evening, his symptoms worsened. Zach’s chest pains were excruciating – forcing him to take rapid shallow breaths. Zach’s mother, Kelly Tripet, raced him over to Community Medical Center’s (CMC) Emergency Department, where it was quickly determined that he had a collapsed left lung (pneumothorax).

CMC’s team promptly stabilized Zach’s condition and arranged for his transfer to The Unterberg Children’s Hospital at Monmouth Medical Center where he was seen by Loki Skylizard, M.D., Chief of Thoracic Surgery, Director of Minimally Invasive and Robotic Thoracic Surgery and Director of the Thoracic Surgical Oncology program. After meeting with Zach and his parents and reviewing his history, Dr. Skylizard recommended video-assisted thoracoscopic surgery (VATS) – a minimally invasive approach – to treat the condition. 

Spontaneous pneumothorax may occur with no apparent injury or trauma. It’s more common in tall, slender, athletic individuals or smokers. It occurs when abnormal, small, air-filled sacs in the lung called “blebs” rupture and leak air into the pleural space (chest cavity). Typically, there are no advanced warning signs. Symptoms can be sudden and frightening – usually shortness of breath and sharp pain like Zach experienced. 

Through the VATS procedure, Dr. Skylizard removed abnormal sections of Zach’s lung that contained blebs and caused the leak. “Since you can’t remove every section, I deliberately remove the inside lining of the chest (pleura) to produce chest wall inflammation. This inflammation causes the lung to fuse to the chest wall. The lung no longer collapses because it fuses with the chest wall. You’ve obliterated that potential ‘space’ between the lung and chest wall so there’s no place for air to fill,” said Dr. Skylizard. 

Traditional surgery requires a large incision through the major chest wall muscle causing significant pain, and a higher risk of infection, blood loss and long-term chest wall muscle dysfunction. By using the VATS procedure, Dr. Skylizard made small incisions which provided Zach with less pain a quicker full recovery.

“Dr. Skylizard was reassuring and made us feel comfortable in a very scary situation,” said Kelly. “He took the time to explain everything in great detail – I couldn’t ask for a better surgeon for my son. I’m determined to make more people aware of spontaneous pneumothorax so they can take quick action and experience a positive outcome.”

Zach underwent respiratory therapy at home where he essentially retrained his body to breathe regularly and fully expand his chest by overcoming his body’s natural tendency to breathe shallow.

Zach had his eyes set on returning to the field this summer as he was selected to play for the prestigious United Lacrosse – Team United NJ. On the first day of practice, however, Zach experienced new sharp pains now on the right side of his chest when he breathed. He immediately called Dr. Skylizard and was rushed to the Emergency Department at Monmouth Medical Center. A chest X-ray determined there was a new, small air pocket and stable partial collapse in his other lung – the right one. Two weeks later, Dr. Skylizard performed a VATS procedure on Zach’s right lung. Zach experienced a quicker recovery following this surgery. He’s currently reconditioning himself with cardiovascular exercise and weightlifting.  

“Both VATS procedures – right and left – were a success and I’m confident that Zach – a highly motivated, healthy athlete – will have no limitations. This is extremely important especially in younger patients. Without a definitive surgical intervention, Zach’s career options and even leisure activities could be seriously restricted by any ongoing risk of recurrent pneumothorax,” said Dr. Skylizard. Soon after, Zach was 100-percent cleared to return to full unrestricted activity. 

According to Zach, “Dr. Skylizard motivated me through rehab and kept me on track. He always stopped by to check on me and helped me cope and get through this experience. He’s not only my doctor but my good friend.”

Zach and Dr. Skylizard developed a friendship through this experience and have plans to go fishing and possibly on a scuba diving excursion in Florida.

About Monmouth Medical Center

Located in Long Branch, N.J., Monmouth Medical Center, a Barnabas Health facility, along with The Children’s Hospital at Monmouth Medical Center, is one of New Jersey's largest academic medical centers and has been a teaching affiliate of Philadelphia’s Drexel University College of Medicine for more than 40 years. From its earliest days, Monmouth Medical Center has been a leader in surgical advancement and has introduced many technological firsts to the region, including robotic surgery and other minimally invasive techniques. The hospital is routinely recognized by HealthGrades, the nation’s largest premier independent health care quality company, for excellence in both emergency medicine and maternity care. U.S. News & World Report has recognized Monmouth as a regional leader in cancer, geriatrics, gynecology, neurology and neurosurgery. For more information on Monmouth Medical Center, visit www.barnabashealth.org.