Letter from the Chief

Min P. Kim, MD, FACS
Vice-Chair of Department of Surgery, David M. Underwood Distinguished Professor of Surgery, Head, Division of Thoracic Surgery, Professor of Surgery and Cardiothoracic Surgery at Weill Cornell Medicine, Professor of Surgery and Cardiothoracic Surgery at Institute of Academic Medicine

Houston Methodist Hospital has once again been recognized for excellence in patient care, earning a position on the U.S. News & World Report Honor Roll and ranked number 1 in the state of Texas. This national recognition reflects our institution’s dedication to leadership in clinical outcomes, research, and patient-centered care. Of particular note, Houston Methodist ranked #8 in Pulmonary & Lung Surgery, #7 in Gastroenterology & GI Surgery, and #19 in Cancer. These rankings speak directly to the quality of care delivered by our multidisciplinary teams—and the Division of Thoracic Surgery has been a key contributor to this success.

Quality in thoracic surgery requires more than technical expertise; it demands continuous improvement, thoughtful evaluation, and a commitment to doing what is best for each patient. Over the past several years, our division has focused on adopting new technologies, refining surgical techniques, and developing evidence-based perioperative protocols. Each change was driven by the same guiding question: Will this improve outcomes and the experience for our patients?

Our surgeons have been instrumental in this process. Their willingness to explore, study, and integrate innovations—while maintaining precise and compassionate clinical care—has led to safer operations, faster recovery, and improved long-term outcomes. Equally important has been the dedication of our advanced practice providers, residents, fellows, nurses, and medical assistants. Their adaptability and teamwork have ensured that new approaches are implemented thoughtfully and seamlessly, keeping the patient experience at the center of every decision.

As we celebrate these national honors, we also look
forward. Our commitment to quality is not a destination but an ongoing journey. We remain excited about the work ahead—continuing to improve surgical care, elevate training, strengthen research, and support patients and families during some of the most challenging moments of their lives.

We are proud of our division. We are proud of our team. But most of all, we are proud to provide high-quality, patient-centered care that makes a meaningful difference.

Min P. Kim, MD, FACS

November is Lung Cancer Awareness Month

November marks Lung Cancer Awareness Month, an important time to highlight progress in prevention, early detection, and treatment of the leading cause of cancer-related death worldwide. Lung cancer remains a significant public health challenge, with approximately 230,000 new cases diagnosed each year in the United States. Historically, survival rates were low because most patients presented with advanced disease. However, meaningful advances in smoking cessation efforts and early screening are changing this trajectory. Over the past several decades, national reductions in smoking have led to a steady decline in lung cancer incidence and mortality. At the same time, the adoption of low-dose computed tomography (LDCT) screening has enabled clinicians to
detect lung cancer at earlier, more treatable stages. Studies show that LDCT screening can reduce lung cancer deaths by up to 20 percent in high-risk individuals. When detected early, patients may be eligible for surgical resection or targeted, less invasive therapies, significantly improving long-term survival.

Primary care providers play a crucial role in identifying patients who qualify for screening. Current guidelines recommend annual LDCT screening for individuals who meet all of the following criteria:

• Age 50 to 80 years
• A history of smoking at least 20 pack-years
• Currently smoke or have quit within the past 15 years

Providers are encouraged to discuss screening with eligible patients, reinforce smoking cessation strategies, and guide them toward comprehensive lung health care. Early detection saves lives, and ongoing collaboration across primary care, pulmonology, and thoracic surgery
continues to expand access to timely diagnosis and treatment.

As we recognize Lung Cancer Awareness Month, we acknowledge the progress made and remain committed to improving outcomes through prevention, education, and early intervention.

Congratulations to Dr. Ray Chihara on His Appointment as Lung Transplant Surgical Director

Ray K. Chihara, MD, PhD

We are pleased to announce the appointment of Dr. Ray Chihara as the Lung Transplant Surgical Director at Houston Methodist Hospital. This is an exciting milestone for our division and the J.C. Walter Jr. Transplant Center, reflecting our continued commitment to excellence in lung transplant care.

Dr. Chihara completed his medical degree and general surgery residency at the Indiana University School of Medicine, where he also earned a Doctorate in Cellular and Integrated Physiology, grounding his clinical work in a deep understanding of translational science. He then pursued advanced
training in thoracic surgery at Emory University Hospital in Atlanta, where he refined his expertise in complex thoracic and transplant procedures.

Since joining Houston Methodist in August 2018, Dr. Chihara has been a key contributor to the growth and clinical success of our Lung Transplant Program. He has performed numerous lung transplants and has consistently demonstrated exceptional surgical skill, thoughtful leadership, and a steadfast commitment to patient-centered care. His collaborative approach has strengthened multidisciplinary coordination and enhanced outcomes for our patients.

In his new role as Surgical Director, Dr. Chihara will lead the operative and strategic direction of the Lung Transplant Program. His vision, dedication, and
expertise will continue to advance our mission of providing world-class transplant care and expanding the program’s regional and national impact.

Please join us in congratulating Dr. Ray Chihara on this well-deserved appointment and in supporting him as he steps into this important leadership role. We look forward to the continued success and innovation he will bring to our program.

Welcome Dr. Deven Patel to the Division of Thoracic Surgery

Deven C. Patel, MD, MS

The Division of Thoracic Surgery is pleased to announce the addition of Dr. Deven Patel to our faculty. Dr. Patel brings an exceptional blend of clinical training, academic accomplishment, and innovative research that aligns seamlessly with our mission to advance patient-centered, high-quality surgical care.

Dr. Patel earned his medical degree from Michigan State University’s College of Human Medicine, where he was inducted into the Alpha Omega Alpha Honor Medical Society in recognition of his academic excellence and commitment to the ideals of the profession. He completed his general
surgery residency at Cedars-Sinai Medical Center in Los Angeles, California, followed by a cardiothoracic surgery fellowship at The Johns Hopkins Hospital in Baltimore, Maryland—one of the nation’s most prestigious training programs.

In addition to his medical training, Dr. Patel holds a Bachelor of Science in Biomedical Engineering from the University of California, San Diego, and a Master of Science in Biomedical Engineering from California Polytechnic State University, San Luis Obispo. His engineering background continues to shape his approach to thoracic surgery, inspiring research focused on innovation in operative techniques, device development, and improved postoperative recovery. He has authored multiple publications in high-impact journals and has been recognized with numerous research and professional awards.

Dr.
Patel’s arrival strengthens our division’s longstanding commitment to advancing surgical excellence through innovation, scientific inquiry, and compassionate care. We are delighted to welcome Dr. Patel to Houston Methodist and look forward to the contributions he will make to our patients, educational programs, and research initiatives. His dedication to advancing the field further elevates our shared vision of delivering world-class, patient-centered thoracic surgery care.

Amber Breindel Joins the Division of Thoracic Surgery

We are pleased to welcome Amber Breindel, DNP, RN, APRN-BC to the Division of Thoracic Surgery as our newest Nurse Practitioner. Amber brings a strong clinical background in cardiothoracic and orthopedic surgery, along with extensive inpatient and outpatient care experience.

Amber earned both her Bachelor of Science in Nursing and her Doctor of Nursing Practice from the University of Pittsburgh, where she also completed her Adult-Gerontology Acute Care Nurse Practitioner training. She began her career caring for postoperative cardiothoracic patients and has since developed
expertise in managing surgical populations across thoracic, orthopedic, and sports medicine settings.

Amber Breindel, DNP, RN, APRN-BC

Her prior work included first-assisting in the operating room, managing complex postoperative recovery pathways, and coordinating longitudinal care for patients across hospital and clinic environments.  Most recently, Amber served as an Advanced Practice Registered Nurse at Baylor College of Medicine, providing evaluation and treatment for patients with orthopedic and sports-related conditions in an outpatient clinical setting.

Her commitment to patient-centered care, clear communication, and thoughtful clinical decision-making make her an excellent addition to our team. In her new role with Thoracic Surgery,
Amber will support perioperative management, inpatient care coordination, and outpatient clinical services. Her experience, adaptability, and genuine compassion for patients will enhance the continuity and quality of care we provide. Please join us in welcoming Amber to the team. We are delighted to have her with us and look forward to the important contributions she will make to our division and our patients.

Congratulations to Dr. Warren Naselsky for Presentation at iMig Meeting

Warren C. Naselsky, MD, MS

We are proud to congratulate Dr. Warren Naselsky on his presentation at the Young Investigators Session during the 17th International Mesothelioma Interest Group (iMig) Meeting in Philadelphia. His talk, titled “From Bench to Bedside: A Young Physician-Scientist’s Journey in Mesothelioma Research,” was delivered on October 28, 2025.

Dr. Naselsky is a thoracic surgeon at Houston Methodist Hospital with a primary clinical and academic focus on pleural mesothelioma and other thoracic cancers. He completed his integrated cardiothoracic surgery training at
the University of Maryland, followed by an NIH T32 postdoctoral fellowship in cancer biology, where he studied cancer stem cell models of mesothelioma. His ongoing clinical research explores innovative surgical strategies and intraoperative therapies aimed at improving outcomes for patients living with this challenging disease.

This presentation highlights not only Dr. Naselsky’s scientific depth and surgical expertise, but also his dedication to advancing mesothelioma care through meaningful translational research. He has previously been recognized as an IASLC Young Investigator and has presented award-winning work at past iMig conferences.

We are honored to have Dr. Naselsky represent the Division of Thoracic Surgery and Houston Methodist on the international stage. Please join us in congratulating him on this achievement and in celebrating his continued leadership in the future of mesothelioma research and
care.

Division of Thoracic Surgery Presents at the American College of Surgeons Clinical Congress 

Left to Right: Samaar Semaan, Madhivanan Elango, Robert Brumer, Steven Elzein, Luis Hernandez Flores, Julia Schroer, Kendall Howard

We are excited to share that our Division of Thoracic Surgery had a strong presence at this year’s American College of Surgeons Clinical Congress. Our team contributed to podium sessions with colleagues from across the country, highlighting Houston Methodist as a leader in thoracic surgery. We are proud of our presenters and grateful to everyone who supported this outstanding representation of our work on the national stage.

Kendall Howard, MD 
General Surgery Resident

Optimizing Robotic Precision in Left Upper Lobe Trisegmentectomy

At the American College of Surgeons Clinical Congress, Dr. Kendall Howard presented on “Optimizing Robotic Left Upper Lobe Trisegmentectomy: Enhancing Precision with EndoLeader and ICG Angiography,” focusing on technical strategies to improve accuracy and safety during segmental lung resection. Dr. Howard demonstrated how the EndoLeader facilitates safe passage around hilar structures, enabling safe stapling the pulmonary artery branch, pulmonary vein, parenchyma, and bronchus without undue tension. He also highlighted the use of indocyanine green
(ICG) angiography following arterial division to define the intersegmental plane and confirm perfusion to the preserved lung, guiding precise parenchymal division and helping reduce postoperative air leak. The presentation underscored how combining thoughtful instrument use with fluorescence-based perfusion mapping enhances anatomic precision, preserves lung function, and supports improved surgical outcomes.

Steven Elzein, MD
General Surgery Resident

Advancing Robotic Esophageal Surgery

Our division is pleased to share that Dr. Steven Elzein presented at the American College of Surgeons Clinical Congress in Chicago on robotic enucleation of an esophageal mass using a suture-based traction technique. The presentation focused on how robotic instrumentation, combined with strategically placed sutures on the tumor, can provide stable counter-traction and improve exposure of the dissection plane. This approach supports precise enucleation while protecting the underlying mucosa and maintains the advantages of minimally invasive robotic esophageal surgery. We commend Dr.
Elzein for his contribution to advancing technique and outcomes in robotic thoracic surgery.

Parth Malaviya 
EnMed Medical Student

Innovating Lung Nodule Localization

Texas A&M EnMED medical student Parth Malaviya, working under the mentorship of thoracic surgery fellow Dr. Anuj Shah, presented their work at the American College of Surgeons Clinical Congress in Chicago on “Shape-sensing robotic bronchoscopy in lateral decubitus position for precise lung nodule localization and resection.” Their study introduced a technique in which shape-sensing robotic bronchoscopy is performed with the patient already positioned laterally for surgery, allowing immediate transition to resection without repositioning. This approach streamlines
workflow in the operating room, reduces anesthesia and operative time, and improves efficiency while maintaining accuracy in nodule localization. The presentation highlighted how close collaboration between surgical trainees and engineering-focused medical students can drive meaningful clinical innovation that directly enhances patient care.

Advancing Techniques in Hiatal Hernia Repair

Research fellow Dr. Samaar Semaan, in collaboration with general surgery resident Dr. Jacobucci, presented their work at the American College of Surgeons Clinical Congress on “Robot Assisted Laparoscopic Repair of Type III Hiatal Hernia Using EndoFLIP as a Bougie.” Their study explores the use of the EndoFLIP device as an intraoperative tool to guide esophagogastric junction calibration during robotic hiatal hernia repair, offering an alternative to the traditional bougie dilator. By providing real-time measurements of luminal diameter and distensibility, EndoFLIP
allows surgeons to tailor the crural closure and fundoplication with greater physiologic precision, potentially reducing the risk of postoperative dysphagia while maintaining reflux control. The presentation highlighted the benefits of combining advanced robotic techniques with functional assessment technology to enhance patient outcomes, and showcased the impact of collaborative research among fellows and residents in refining operative strategies and driving surgical innovation.

Samaar Semaan, MD
Research Fellow

Dr. Warren Naselsky Showcases Rare Mesothelioma Case at iMig 2025

We are pleased to recognize Dr. Warren Naselsky for his presentation at the 17th International Conference of the International Mesothelioma Interest Group (iMig), held in Philadelphia, PA on October 28, 2025. iMig is the world’s leading scientific forum for the discussion and advancement of research, diagnosis, and treatment of mesothelioma. Dr. Naselsky’s contribution reflects the Division of Thoracic Surgery’s ongoing commitment to clinical innovation and academic leadership.

Dr. Naselsky presented a compelling case titled: “A Rare Case of Localized Biphasic
Pleural Mesothelioma Presenting as an Incidentally Discovered and Robotically Resected Diaphragm Mass.” The case highlighted an unusual presentation of biphasic pleural mesothelioma, a rare and clinically challenging tumor subtype characterized by both epithelial and sarcomatoid components. In this patient, the tumor was discovered incidentally and located along the diaphragm—an uncommon site and presentation that can complicate both diagnosis and surgical planning.

Dr. Naselsky discussed the multidisciplinary evaluation required to differentiate the mass from other thoracic and abdominal pathologies, the role of advanced imaging in defining surgical approach, and the benefits of robotic resection in managing select cases of
localized pleural tumors. The robotic platform allowed enhanced visualization and precision during dissection, offering a minimally invasive option while achieving oncologic control.

This presentation underscores the importance of clinical vigilance when evaluating atypical thoracic findings and demonstrates how robotics can expand safe surgical options for carefully selected mesothelioma cases. It also highlights our division’s dedication to thoughtful, patient-centered innovation in complex thoracic disease management.

We congratulate Dr. Naselsky on representing our program on the international stage
and contributing valuable insight to the global mesothelioma research and clinical community.

David M. Underwood Lecture in Lung Transplantation Highlights Landmark Robotic Innovation 

We were honored to welcome Dr. Emerson as this year’s David M. Underwood Lecturer in Lung Transplantation at Houston Methodist Hospital. Dr. Emerson, who performed the first robotic lung transplantation in the United States, delivered an inspiring program that traced the journey from an early concept sketched on a paper napkin to a successful clinical reality. Hearing how vision, persistence, and collaboration transformed an idea into a historic achievement was truly remarkable.

In addition to his lecture, Dr. Emerson led a hands-on session during our Robotic Thoracic Surgery Symposium at the MITIE Bookout Center. Faculty, fellows, and residents—especially Drs. Ray Chihara and Warren Naselsky—benefited greatly from his insights into procedural planning, technical refinements, and intraoperative decision-making. His visit has directly helped us begin building the foundation for a robotic lung transplantation program at Houston Methodist.

We are grateful to Dr. Emerson for sharing his expertise and for inspiring continued innovation within our division. His visit represents an
exciting step in advancing our capabilities and strengthening our leadership in cutting-edge thoracic surgery.

Grand Rounds Highlight: Advancing Surgical Quality Through Innovation and Enhanced Recovery

Min P. Kim, MD

Last month, Dr. Min P. Kim delivered the Surgical Grand Rounds presentation titled “Improving Surgical Quality Through Innovation, Surgeon Specific Reporting and Enhanced Recovery Protocols.” Dr. Kim emphasized that meaningful improvements in surgical outcomes require a comprehensive and intentional approach — one that integrates technological innovation, data transparency, and evidence-based perioperative pathways.

Dr. Kim discussed how robotic surgery and advanced minimally invasive techniques can enhance precision, reduce complications, and improve patient recovery when
implemented thoughtfully. He also highlighted the importance of surgeon-specific reporting as a tool to drive personal accountability and collective excellence. By openly tracking outcomes and analyzing performance metrics, surgeons and teams can identify opportunities for improvement and share best practices across the division.

A central component of the talk focused on Enhanced Recovery After Surgery (ERAS) protocols, which standardize perioperative care to minimize variability, decrease hospital length of stay, and promote faster return to function. Dr. Kim shared the division’s progress in ERAS implementation and emphasized ongoing collaboration among anesthesia, nursing, physical therapy, and the broader care team.

The presentation reinforced a shared commitment: delivering the highest standard of care to patients, while continuously evolving through innovation, transparency, and teamwork.

Benchmarking Pulmonary Resection Outcomes Using Vizient Data

Congratulations to Dr. Anuj Shah on the recent publication from our division that advances quality measurement and performance benchmarking in thoracic surgery: “Using Vizient database for benchmarking pulmonary resection outcomes,” published in the Journal of Thoracic Disease.

This study evaluates how the Vizient clinical database can be used to compare pulmonary resection outcomes across institutions, offering a more standardized and transparent framework for performance assessment. By analyzing national data and identifying key quality indicators, the team demonstrates how Vizient benchmarking helps
institutions better understand their outcomes relative to peer hospitals and identify meaningful opportunities for improvement.

Anuj Shah, MD
Cardiothoracic Fellow

This work reflects our division’s ongoing commitment to data-driven quality improvement, surgical excellence, and patient-centered outcomes. It also supports our strategic priority of aligning institutional performance metrics with national standards and further reinforces Houston Methodist’s reputation as a leader in thoracic surgery.

Spotlight on Clinical Innovation: Recent Case Reports from Our Division

We are pleased to congratulate Drs. Howard, Loreno, and Wang as first authors on three recently published case reports that showcase the thoughtful clinical judgment, technical expertise, and ongoing academic contributions within our division. Dr. Howard led the publication “Robotic-Assisted Lobectomy Following Induction Chemoimmunotherapy Achieves Complete Pathologic Response in Stage IIIA Lung Adenocarcinoma” in Cureus, highlighting the role of robotic surgery in the era of immunotherapy for locally advanced lung cancer. Dr. Loreno’s case report, also in Cureus, “Creating a Straight Conduit: The Pleural Closure Technique in Ivor Lewis
Esophagectomy,” describes a practical operative strategy to improve conduit alignment and efficiency during esophagectomy. Dr. Wang’s publication in Annals of Thoracic Surgery Short Report, “Esophageal Duplication Cyst: A Rare Cause of Esophagogastric Junction Obstruction,” illustrates the diagnosis and management of an uncommon foregut lesion causing obstructive symptoms. Together, these publications reflect our division’s commitment to sharing valuable clinical experience, advancing surgical knowledge, and continually improving patient care. Please join us in congratulating Drs. Howard, Loreno, and Wang on their accomplishments.

Meet our Thoracic Surgery Team

Min P. Kim, MD 

Ray K. Chihara, MD, PhD

Warren C. Naselsky, MD, MS

Deven C. Patel, MD, MS

Left to Right: Dr. Ray K. Chihara, Dr. Deven C. Patel, Dr. Min P. Kim, Dr. Warren C. Naselsky