What is VATS Surgery?
Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgical procedure used to diagnose and treat conditions inside the chest, including the lungs, pleura, and mediastinum.
Instead of making a large incision, the surgeon uses minor cuts through which a tiny camera (thoracoscope) and special instruments are inserted. The camera provides a clear view of the chest cavity on a monitor, allowing the surgeon to perform the procedure with precision.
VATS is commonly recommended for patients with lung tumours, infections, pleural effusions, or certain oesophageal conditions. It is also used for biopsies and to treat complications inside the chest.
Compared to traditional open-chest surgery (thoracotomy), VATS usually results in less pain, shorter hospital stays, quicker recovery, and fewer scars.
Types of VATS Procedures
Video-assisted thoracoscopic Surgery (VATS) is a minimally invasive surgical technique used for diagnosing and treating various thoracic conditions. Here are its key therapeutic applications:
- Lobectomy: Removal of a lobe of the lung, commonly performed to treat lung cancer or damaged lung tissue.
- Mediastinal Tumor or Chest Wall Tumor Removal: Effective for excising tumors located in the mediastinum or chest wall with reduced trauma and quicker recovery.
- Air Bubble Removal: Treats pneumothorax by removing air bubbles trapped between the lung layers.
- Mechanical or Chemical Pleurodesis: Prevents recurrent fluid accumulation or pneumothorax by sealing the pleural space.
- Esophageal Diverticula Removal: Removes pouch-like structures in the esophagus to improve swallowing and reduce symptoms.
- Thoracic Duct Ligation: Treats chylothorax (leakage of lymph fluid into the pleural cavity).
- Sympathectomy: Cauterizes or removes sympathetic nerves to treat conditions like excessive sweating (hyperhidrosis) or Raynaud's phenomenon.
- Thoracoscopic Laminectomy: A minimally invasive procedure to treat spinal conditions by removing part of the vertebral bone.
1-3 Hours
Procedure Duration
General Anesthesia (+ Local at Incision Sites)
Anesthesia Used
1-3 Weeks (Normal in 1-2 Weeks; Avoid Strain 4-6 Weeks)
Recovery Timeline
When is Video-assisted Thoracoscopic Surgery (VATS) Recommended?
VATS is recommended for patients when chest or lung conditions cannot be managed with medications or less invasive treatments. Some of the main reasons include:
- Lung Cancer or Suspicious Tumours: When a mass is detected in the lungs, VATS allows biopsy or removal of the affected tissue/lobe while minimising surgical trauma.
- Pleural Effusion (Fluid Around the Lungs): For persistent or recurrent fluid buildup in the chest that causes breathlessness, VATS helps drain the fluid and treat the underlying cause.
- Collapsed Lung (Pneumothorax): In cases of repeated lung collapse, VATS is used to repair leaks and prevent recurrence.
- Infections or Empyema: Severe chest infections that cause pus or thickened tissue around the lungs can be effectively treated with VATS decortication.
- Lung Biopsy: For diagnosing interstitial lung disease, tuberculosis, or unexplained chest conditions, a minimally invasive biopsy via VATS provides accurate results.
- Oesophageal and Mediastinal Conditions: Certain problems of the oesophagus or mediastinum (central chest area) may also be treated using VATS techniques.
Preparing for Video-assisted Thoracoscopic Surgery Procedure
Preparing for your VAT surgery is a key part of a smooth surgery and a fast recovery.
Medical Evaluation & Pre-Op Tests
- A detailed review of your medical history, current medications, and lifestyle habits.
- Routine tests such as blood work, ECG, chest X-ray, lung function tests, or CT scans to assess surgical readiness.
- Results are reviewed before surgery to finalise the treatment plan and address any risks.
Health Habits & Lifestyle Adjustments
- Quit smoking at least 4-6 weeks before surgery, as it improves lung function and healing.
- Avoid alcohol and stop taking blood-thinning medications (aspirin, NSAIDs, vitamin E, herbal supplements) at least 1-2 weeks before surgery.
- Eat a balanced diet rich in protein, vitamins, and minerals to strengthen the immune system and aid recovery.
Preparing Your Home & Support System
- Arrange for someone to drive you to and from the hospital.
- Prepare a comfortable recovery space with pillows, medications, water, and easy-to-reach essentials.
- Keep light meals or soups ready to make eating easier during the initial recovery days.
The Day Before & Day of Surgery
- Follow fasting instructions - usually no food or drink after midnight.
- Shower with antiseptic soap if instructed, and avoid using lotions, perfumes, or nail polish.
- Wear loose, front-opening clothes and remove jewellery before heading to the hospital.
What Happens During Video-assisted Thoracoscopic Surgery (VATS) Surgery?
VATS (Video-Assisted Thoracoscopic Surgery) is performed under general anesthesia. A breathing tube is placed to enable regular breathing. Here, the surgery begins following the steps shown below:
- Preparation & Anesthesia: On the day of surgery, the medical team reviews your case once more. General anaesthesia is given so you are fully asleep and pain-free throughout the procedure.
- Small Incisions & Camera Placement: The surgeon makes 2–4 small incisions between the ribs. A thoracoscope (tiny camera) is inserted through one incision, projecting a high-definition view of the chest cavity on a monitor.
- Surgical Instruments & Treatment: Special instruments are inserted through the other incisions. Depending on your condition, the surgeon may take a biopsy, remove diseased lung tissue, drain fluid, or repair affected areas.
- Precision with Minimally Invasive Technique: Unlike open-chest surgery (thoracotomy), VATS avoids large incisions, which reduces trauma, blood loss, and recovery time.
- Closing the Incisions: After dissecting the procedure, the instruments are taken out, and incisions are neatly sutured with surgery glue or a needle. Temporary placement of a small chest tube, to drain air or fluid, can be done.
- Post-Surgery Care: You will be observed in the recovery section and most patients are advised to walk within 24 hrs so as to enhance breathing and circulation. The stay in hospitals is normally shorter than open surgery.
Who Performs Video-Assisted Thoracoscopy Surgery?
Thoracic surgeons are specialists who perform surgeries on the chest and its organs. They are typically the ones who carry out VATS (Video-Assisted Thoracoscopic Surgery) procedures.
If you're experiencing symptoms like chest pain or breathing difficulties or have been diagnosed with a chest condition that might need surgery, it's important to seek medical advice. Start by consulting your primary care doctor or a pulmonologist(lung specialist). They will evaluate your condition and, if necessary, refer you to a thoracic surgeon for further care.
Recovery After Video-assisted Thoracoscopic Surgery (VATS)
Recovering from VATS occurs in stages, and proper care ensures a smooth healing process.
First Few Days After Surgery
- Mild chest pain, soreness, and shortness of breath are common.
- A chest tube may remain for 1-3 days to drain air or fluid.
- Gentle walking and breathing exercises are started early to improve lung function and prevent complications.
Doctor's Tip: "Pain and breathing discomfort are expected. Take medicines on time and keep doing your breathing exercises."
Weeks 2 to 4
- Pain and swelling reduce, making movements easier.
- A majority of patients are able to resume a light daily activity, including walking, domestic chores or office work.
- Lifting heavy and hard work should be avoided.
Doctor's Tip: "Don't rush. Let your body guide you - short rest breaks are excellent during this stage."
Weeks 5 to 6
- Energy levels improve, and most patients return to work if it's not physically demanding.
- Breathing feels stronger, and chest discomfort continues to decrease.
- Strenuous exercise should be avoided until cleared by your surgeon.
Doctor's Tip: Even if you feel normal, your tissues are still healing inside. Wait for your surgeon's approval before exercising.
3 to 6 Months Post-Surgery
- Most patients achieve complete recovery with improved breathing and strength.
- Scars become less visible, and the long-term benefits of VATS are noticeable.
- Regular follow-ups help ensure lasting results and detect any complications early.
Doctor's Tip: "Keep attending follow-up visits. Monitoring lung health after surgery is just as important as the surgery itself."
Benefits of VAT Surgery
- Minimally Invasive Approach: Small incisions instead of a large chest cut, leading to less pain and trauma.
- Faster Recovery: Shorter hospital stays (2-5 days) and quicker return to daily activities compared to open surgery.
- Reduced Complications: Lower risk of bleeding, infection, and breathing difficulties.
- More minor Scars: Cosmetic benefits with minimal scarring.
- Better Postoperative Comfort: Less reliance on pain medication and improved mobility soon after surgery.
- Effective Outcomes: Equally successful in treating lung cancer, pleural conditions, and chest infections when compared to traditional surgery.
Risks of VATS
- Bleeding or Infection: Although rare, any surgery carries a risk of bleeding or infection at the incision site.
- Air Leaks from the Lung: Sometimes air can escape from the lung, requiring a longer chest tube placement.
- Conversion to Open Surgery: In complex cases, the surgeon may need to switch to thoracotomy (open surgery) for safety.
- Anaesthesia Risks: Side effects such as nausea, dizziness, or reactions to anaesthesia may occur.
- Breathing Difficulties Post-Surgery: Temporary shortness of breath or reduced lung function may persist during early recovery.
- Rare Complications: Injury to nearby organs, blood clots, or nerve damage may occur, but are uncommon..
What is the cost of VATS surgery in India?
The cost of VATS surgery in India generally varies depending on the hospital, the complexity of the procedure, surgeon's expertise, and post-surgery care required. On average, it can range from Rs. 1,00,000 to Rs. 5,00,000, with additional costs for tests, ICU stay.
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