Video-Assisted Thoracic Surgery (VATS)

What is video-assisted thoracic surgery (VATS)?

Video-assisted thoracic surgery (VATS) is a type of minimally invasive thoracic surgery that can remove parts of the diseased lung and lymph nodes. In video-assisted thoracoscopic surgery (VATS), a small tube called a thoracoscope is inserted through a small cut (incision) between the ribs. At the end of the tube is a small camera. This lets the surgeon see the entire chest cavity without having to open up the chest or spread the ribs. The surgeon then removes lung tissue with specially designed instruments inserted through one or two additional small incisions. The VATS technique can be used for other types of chest procedures involving the lungs, esophagus, thymus, pleural or pericardium besides lung cancer surgery.

Learn more about surgical techniques and other types of lung cancer surgery here. 

What to expect?

• Your doctor will discuss with you what you need to do to prepare for surgery.
• Your surgery will begin with you being placed under general anesthesia.
• Once you are asleep, a breathing tube is placed into your airway to allow each lung to be separately inflated during surgery.
• You are then positioned on your side.
• The surgeon will make several small cuts (incisions) in your thoracic (chest) area between your ribs.
• The thoracoscope and other tools are inserted through these incisions.
• The surgeon uses these tools to remove part of the lung and lymph nodes, drain fluid from around the lung, or do a procedure on other chest organs.
• At the end of the surgery, the surgeon will insert a chest tube through one of the small incisions to drain fluid or air leaking into the chest cavity and to help your lungs re-inflate. This tube remains in place for a few days and is typically removed at the bedside before you go home.
• Patients are usually discharged from the hospital a few days after surgery.
• It is important to give yourself time to rest when you go home. Gradually you will get stronger and feel like yourself in a few weeks. Follow any post-operative instructions from your doctor.

What are the risks and benefits?

All types of surgery carry risks. They may include but are not limited to blood clots, infection, bleeding, abnormal heartbeats, air leakage from your lungs and pain.

The main benefit of VATS is that it uses smaller incisions and does not require spreading of the ribs required to perform open surgery.  Less trauma leads to less pain and a quicker recovery.

Each person handles surgery a little differently and your outcomes may depend on a number of factors, like your health history, the type of lung cancer you have, the planned procedure and/or your surgeon's experience.

Who is eligible?

Eligibility for VATS is determined on a case-by-case basis. In terms of lung cancer surgery with VATS, patients are generally eligible as a first-line treatment if they have early-stage disease (stage 1 or 2). Sometimes patients will receive lung cancer surgery after another type of treatment like chemotherapy or radiation is used to shrink the tumor. When you are considering a lung surgery, be sure to find a surgeon well-trained in minimally invasive surgical techniques. A highly skilled surgeon can perform surgery in a variety of ways and will explain which is the best option for your particular case.