Overview

VATS (Video-assisted thoracoscopic surgery) is a minimally invasive surgery used to diagnose and treat illness or injury to the lungs and other organs in the chest cavity. A tiny camera called a thoracoscope and surgical instruments are inserted through the chest wall. The surgeons can perform procedures on the heart or lungs inside the chest using live video imaging on a screen.

Unlike VATS which is a minimally invasive surgical technique to examine and treat chest related problems; thoracotomy is a major operative procedure which is done to open the chest and diagnose or treat lungs or other organs in the chest cavity.


Indications

  • To take a biopsy from the lung or the lining of the chest wall.
  • To remove abnormal lumps or growths from the lung.
  • Procedures on the heart such as atrial fibrillation ablation, pacemaker lead placement, and mitral valve repair.
  • Removal of lymph nodes
  • Draining pleural effusion
  • Tumour removal
  • Bullectomy
  • Treatment of pneumothorax
  • Lobectomy where one of the lung lobes is surgically removed.

Procedure

Before the Procedure

  • The doctor will perform a physical examination and order a few diagnostic tests such as blood tests, chest x ray, ECG, pulmonary function tests and cardiac evaluation. Doctors may suggest PET scans if they suspect cancer.
  • The doctor will ask about all the medications you are using which includes prescription, over the counter drugs and herbal supplements.
  • The doctor may ask you to discontinue blood thinners like aspirin before the surgery.
  • Make sure to arrange someone to take you to the hospital and bring you back home after the surgery.

During the Procedure

  • VATS is performed in the operating room. A needle will be inserted into a vein to administer fluids and medications. It is usually performed under general anaesthesia, which means you will be asleep during the procedure.
  • Once you are asleep, a catheter may be inserted into your bladder.
  • You will be placed on the operating table. Surgeons operate through 2 to 4 tiny incisions between the ribs in the chest. One of the openings is for a tiny video camera called the thoracoscope and the others are for surgical instruments. The surgeon can view the internal organs of the patient on a television monitor while performing the procedure. Each opening is less than one inch in diameter.
  • After the surgery, the surgeon will insert some small tubes into the chest. These are known as 'chest drains,' and they allow any collected fluid or air to leak out. Any tissue samples taken from your chest or lungs will be sent to a laboratory for analysis.
  • The camera and other instruments will be removed once the procedure is completed.
  • The surgeon will surgically close the chest incisions. A bandage will be applied.

After the Procedure

  • Soreness at the incision sites following a VATS procedure is normally present. These will be closed with stitches or staples, and your doctor will remove them at a follow-up appointment one to two weeks later.
  • When you get home, follow your doctor's aftercare instructions and take medications that are prescribed. For the first few days, you may feel tired.
  • When you feel ready, move on to some gentle exercises like walking, but avoid heavy lifting or strenuous exercises.

Benefits

  • Reduced scarring
  • Decreased postoperative pain
  • Shorter hospital stay
  • Lower risk of complications
  • Better overall surgical outcomes
  • Reduced immunosuppression following surgery
  • Patients can avoid some of the "bone pain" associated with the open approach.

Risks

Many people with VATS do exceptionally well. However, there may be some complications. Some of these are:

  • Air leak
  • Partial collapsed lung (atelectasis)
  • Arrhythmias
  • Profuse bleeding
  • Infection of the wound
  • Blood clots may lead to pulmonary embolism or stroke.
  • Shock
  • Pneumonia
  • Complications from anaesthesia

  • Care at Medicover

    Medicover hospital has the best cardiothoracic surgeons to perform Video assisted thoracoscopic surgery (VATS). The hospital boasts of a tradition of clinical excellence, owing to the outstanding success rates for highly complex procedures. The surgeons are highly experienced and carry skills and knowledge in their area of specialisation. Our surgeons work with the latest technologies in a multi-disciplinary and state-of-the-art hospital set-up. This allows the patients to receive the best possible care for their conditions.


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    Frequently Asked Questions

    1. What is a major advantage of video-assisted thoracoscopic surgery (VATS)?

    When compared to a traditional open operation (thoracotomy), video-assisted thoracoscopic surgery usually results in less pain, fewer complications, and a shorter recovery time.

    2. How long does video assisted thoracoscopic surgery (VATS) take?

    VATS can take two to three hours and require you to stay in the hospital for a few days, depending on the type of the procedure and your condition.

    3. Is VATS a minimally invasive procedure?

    It is considered minimally invasive surgery. It employs a thoracoscope, which is a type of video camera. That is, it makes smaller incisions (cuts) than traditional open surgery.

    4. What are the risks of VATS?

    The risk of video assisted thoracoscopic surgery is air leak, abnormal heart rhythms, excess bleeding, wound infection, blood clot formation, collection of thick pus in the chest cavity(empyema), pneumonia and atelectasis.

    5. How long does it take to drain fluid from lungs?

    It typically takes 10 to 15 minutes, but it can take longer if there's a lot of fluid in your pleural space.

    6. How long will it take to recover from a VATS procedure?

    Stitches or staples will be used in the incisional site. These will be removed by the doctor one to two weeks after your surgery. The length of time you will need to recover is determined by the surgery done. However, you will most likely need to rest at home for at least 1 to 2 weeks.

    7. What muscles are cut during traditional thoracotomy surgery?

    In the majority of the cases, a long incision through the chest muscles is made, and the ribs were cut or spread to allow the surgeon access to the diseased area.

    8. Are ribs broken during a thoracotomy?

    The surgeon may need to break or remove a rib in some cases. The cut runs from your chest to the back, passing under your armpits. The size and precise location of the incision are determined by the type of surgery.

    Citations

    https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/video-assisted-thorascopic-surgery
    https://patient.info/treatment-medication/video-assisted-thoracoscopic-surgery
    https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=135&contentid=395