Video-assisted thoracoscopic surgery (VATS)

Overview

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgical technique used to diagnose and treat problems in the chest.

During a VATS procedure, a tiny camera and surgical tools are inserted into the chest through one or more small cuts in the chest wall. The camera, called a thoracoscope, sends images of the inside of the chest to a video monitor. These images guide the surgeon during the procedure.

Why it's done

Surgeons use the VATS technique for a variety of procedures, such as:

• Tissue removal to diagnose chest cancers, including lung cancer and pleural mesothelioma, a type of cancer which affects the tissue that surrounds the lungs.
• Lung surgery, such as surgery to treat lung cancer and lung volume reduction surgery.
• Procedures to remove excess fluid or air from the area around the lungs.
• Surgery to relieve excessive sweating, a condition called hyperhidrosis.
• Surgery to treat problems with the esophagus, the muscular tube that carries food and liquids from the throat to the stomach.
• Surgery called an esophagectomy to remove part or all of the esophagus.
• Repair of a hiatal hernia, when the upper part of the stomach pushes into the chest through an opening in the diaphragm.
• Surgery called a thymectomy to remove the thymus gland, a small organ just behind the breastbone.
• Certain procedures that involve the heart, ribs, spine and diaphragm.

Risks

Possible complications of VATS include:

• Pneumonia.
• Bleeding.
• Short-term or permanent nerve damage.
• Damage to organs near the procedure site.
• Side effects from anesthesia medicines, which put you in a sleep-like state during the procedure.

VATS can be an option when open surgery is not the best choice due to health concerns. But VATS may not be good for people who have had chest surgery before. Talk with your health care provider about these and other risks of VATS.

How you prepare

You may need to have tests to find out if VATS is a good option for you. These tests may include imaging tests, blood tests, lung function tests and a heart evaluation.

If you're scheduled for surgery, your health care provider will give you specific instructions to help you prepare.

What you can expect

Usually, VATS is done with general anesthesia. That means you're in a sleep-like state during surgery. A breathing tube is placed down your throat into your windpipe to provide oxygen to your lungs.

Your surgeon then makes small cuts in your chest and inserts specially designed surgical tools through these cuts to do the procedure.

VATS typically takes 2 to 3 hours. You may need to stay in the hospital for a few days. But the times can vary, depending on the procedure you have and your situation.

Results

In a traditional open surgery, called a thoracotomy, a surgeon cuts open the chest between the ribs. Compared with open surgery, VATS usually results in less pain, fewer complications and shortened recovery time.

If the purpose of VATS is to take a sample of tissue for a biopsy, you may need additional surgery, depending on the results of the biopsy.