About Video Assisted Thoracoscopic Surgery (VATS)
Video Assisted Thoracoscopic Surgery (VATS) is a type of minimally invasive surgery used in the treatment of lung cancer and other medical conditions. In VATS, the a lung surgeon uses small incisions in the patients' chest wall as a point of entry into the lung cavity. The surgeon will then pass a small camera (endoscope) through one of the incisions and view the lungs on a screen in the operating room. The other incisions are used to pass small instruments into the lung cavity to perform a specific operation.
There are many procedures that can be performed using VATS, including:
- lung cancer biopsy for diagnosis of lung cancer
- lung cancer resection (under certain conditions)
- removal of fluid from the lungs
Preparing for Video Assisted Thoracoscopic Surgery
All patients will meet with a lung surgeon before VATS. The surgeon will review the patient’s records and discuss the planned procedure during this meeting. All questions regarding the surgery will be addressed during the consultation. A full evaluation, including laboratory tests, is completed to ensure that there will be no unseen problems during surgery. The surgeon will give specific instructions on which medications to stop prior to your surgery. (Please see our section on preparing for heart surgery for more information).
How is Video Assisted Thoracoscopic Surgery Performed?
On the day of surgery, you will be brought to a pre-op room where you will change into a gown and meet with an anesthesiologist. The anesthesiologist is the physician responsible for putting you to sleep and ensuring that you will not feel pain or remember the events during the procedure. A lung surgeon will then create several small incisions in the patients' chest wall as a point of entry into the lung cavity. These small incisions are known as "ports." The surgeon will then pass an endoscope through one of the incisions. The endoscope is a small instrument with a fiber-optic camera at the end, and allows the surgeon to view the lungs on a screen in the operating room. Air is used to expand the lung cavity and enhance the surgeon's view. The surgeon will then introduce small instruments through the other incisions. These instruments are manipulated to complete the surgery. The surgeon will leave a device known as a "chest tube" in the lung cavity. The chest tube will stay in position after the surgery, and is used to drain any remaining air or fluid during the recovery phase.
After Video Assisted Thoracoscopic Surgery
After video assisted thoracoscopic surgery, the patient will be moved to a recovery area for close monitoring of vital signs and general condition, and medications are given to prevent any pain. The staff will provide specific instructions regarding when to start activity and what type of activity should be done. Activity is started as soon as possible to improve recovery. Special breathing devices are also provided, where the patient takes in large breaths to help re-inflate the lungs. Please see our section on recovery from heart surgery for more information.
Advantages of Video Assisted Thoracoscopic Surgery
The main advantage of VATS is that it is less invasive than traditional surgery, where the chest has to be opened through a long incision in order to gain access to a diseased part of the lung. In VATS, there are usually 3 to 4 small incisions made, typically around 1 inch long. VATS generally has a decreased duration of hospital stay and decreased level of pain when compared to traditional surgical techniques, and patients typically stay in the hospital for 1 to 3 days instead of 5 to 7 days associated with traditional surgery.
Although there may be a shorter recovery time for the patient, many cases are not suitable for VATS. For example, there may not be adequate exposure of the internal organs with this technique. The decision to perform VATS is complicated and should be made by a physician with extensive experience in thoracoscopic surgery.
Risks of Video Assisted Thoracoscopic Surgery
Common risks of video assisted thoracoscopic surgery include bleeding, infection, nerve damage, breathing problems, and air leak through one of the incisions. Your surgeon will discuss these and other risks with you before your operation. Your surgeons and caregivers use many techniques to ensure that these risks are minimized.
If you have any questions regarding video assisted thoracoscopic surgery, please contact us to set up a consultation with one of our lung surgeons.