Medical and clinical research is one of the objectives of the HUG. The development of efficient and minimally invasive diagnostic and therapeutic strategies is the main research mission of the Division.
There are two main areas of research.
- The first, clinical research, focuses on reducing the risk of complications during surgical procedures
- The second, basic research, seeks to improve the treatment of patients with lung cancer and pleural cancer (mesothelioma).
Basic research on lung cancer and mesothelioma is done at the Division's research laboratory, directed by Dr. Véronique Serre-Beinier at the University of Geneva Faculty of Medicine.
Minimally invasive thoracic surgery
Technological developments for the improvement of minimally invasive surgery of the lung and intra-thoracic organs.
In the 2000s, the Division adopted minimally invasive techniques (mainly thoracoscopy) to carry out thoracic procedures. We currently perform 80% of thoracic operations with a minimally invasive approach and are the pioneers in Switzerland in the removal of the thymus using the subxiphoid approach (e.g. for myasthenia gravis).
We are also developing new fluorescence imaging techniques for more precision in limited lung resections (resection of a lung segment, involving resection of smaller amounts of healthy lung tissue than in a lobectomy).
For example, here is a recent article on the subject: Impact of near-infrared angiography on the quality of anatomical resection during video-assisted thoracic surgery segmentectomy
Thyroid surgery and decreased risk of injury to the vocal nerves and parathyroid glands
Neuromonitoring techniques for the recurrent nerve (vocal nerve) were introduced in the Division in 2006 and are systematically used during thyroid and parathyroid procedures. The most state-of-the-art techniques (continuous neuromonitoring) are used in complex situations. These techniques help to identify the vocal nerve and with surgical expertise contribute to a decrease in the risk of voice problems after thyroid surgery.
The Division organizes training courses several times a year for surgeons who wish to expand their knowledge in this field.
In recent years, the Division has pioneered the development of fluorescent parathyroid imaging techniques. These techniques help detect the parathyroid glands and ensure proper vascularity and parathyroid function after resection of the thyroid, significantly contributing to a decrease in the risk of hypocalcemia after thyroidectomy.
For example, here is a recent article on this topic: Randomized clinical trial of intraoperative parathyroid gland angiography with indocyanine green fluorescence predicting parathyroid function after thyroid surgery
Basic research on lung cancer and mesothelioma
The basic research laboratory, directed by Professor Frédéric Triponez and Dr. Véronique Serre-Beinier, focuses on lung cancer and pleural cancer (mesothelioma). The objectives of this research are to identify new therapeutic approaches to control the growth of these cancers.
In the age of personalized medicine, molecular tumor profiling helps identify the therapeutic agent best suited for a patient. But this mapping is not enough to predict a patient's response to a given treatment over an extended period of time. Therefore, we would like to develop a clinical functional test to monitor the response of the tumor in a given patient to one or more treatments. We are currently implementing a method to reconstitute the lung tumor of each patient in vitro as 3D mini-organs (called patient-derived organoids or PDOs). A PDO has the ability to express the same mutations as the original cells taken from a patient's tumor. It will reproduce the person’s specific and genetically unique abnormality. These PDOs that are specific to each patient will allow us to test several anti-cancer agents in parallel and to monitor the effects of active agents over the long term in order to identify the emergence of resistance. We will then be able to test the efficacy of chemotherapeutic or immunotherapeutic treatments alone or in combination. Several very recent studies confirm that PDOs can replicate patient treatment responses in clinical practice and could be valuable tools for personalized medicine.
Pleural mesothelioma is a rare form of cancer that affects the membranes that line the rib cage and the organs it contains (lungs, heart). The majority of patients with this type of very aggressive cancer (mostly men over 50) have been repeatedly exposed to asbestos, usually at their workplaces.
The treatment of mesothelioma currently faces two major limitations: it is diagnosed late because no known symptoms are manifested at the early stage; and mesothelioma cancer cells are resistant to conventional chemotherapy and radiotherapy treatments.
Our laboratory seeks to identify new therapeutic targets that would allow more effective treatments to be developed. We are also interested in the role of inflammatory response at the source, and the multiplication and differentiation of cancer cells. We are particularly focused on the role of an inflammatory cytokine, the MIF (macrophage migration inhibitory factor) molecule, which is capable of increasing the multiplication of cancer cells.
You can find more information and a list of publications on the laboratory’s website