En Español (Spanish Version)

by Stahl RJ

Video-Assisted Thoracic Surgery

(VATS)

Definition

VATS is a type of chest surgery that requires making tiny openings in the chest. During VATS, the doctor makes small, keyhole incisions and uses a tiny camera (called a thoracoscope) and other small tools. Images from the camera are sent to TV monitors. The doctor relies on these images to do the surgery.

Reasons for Procedure

VATS is used to diagnose and treat a range of conditions. Common reasons to undergo VATS include:
  • Diagnosing and treating lung cancer
  • Removing diseased lung sections or lobes
  • Diagnosing lung infections
  • Treating collapsed lungs
  • Draining fluid out of the chest cavity
  • Diagnosing and treating of the thymus (organ in the chest)
Lung Cancer
IMAGE
Copyright © Nucleus Medical Media, Inc.
Compared to traditional procedures, VATS may result in:
  • Less pain and faster recovery
  • Shorter hospital stay
  • Fewer complications
  • Less scarring

Possible Complications

Complications are rare, but no procedure is completely free of risk. If you are planning to have VATS, your doctor will review a list of possible complications, which may include:
  • Infection
  • Bleeding
  • Anesthesia-related problems
  • Air leaking from the lungs
  • Chest pain
  • The need to switch to open chest surgery (eg, to remove a larger area of the lung)
Some factors that may increase the risk of complications include:
  • Pre-existing heart or lung condition
  • Smoking
  • Obesity
  • Diabetes
  • Previous chest surgery
  • Use of certain medicines
Discuss these risks with your doctor before surgery.

What to Expect

Prior to Procedure

Depending on the reason for your surgery, your doctor may do the following:
  • Physical exam and blood tests
  • Pulmonary function tests —to help the doctor determine how well your lungs are functioning
  • CT scan —a type of x-ray that uses a computer to make pictures of structures inside the chest
  • Electrocardiogram (ECG, EKG)—a test that records the heart’s activity by measuring electrical currents through the heart muscle
  • Tests to evaluate how well the heart is functioning
Leading up to the surgery:
  • Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure (eg, aspirin , clopidogrel , warfarin ).
  • If you take insulin, you may need to adjust your dose. Talk to your doctor about this.
  • Arrange for someone to drive you home and to help you at home.
  • Eat a light meal the night before. Do not eat or drink anything after midnight.

Anesthesia

VATS is usually done using general anesthesia . This will block pain and keep you asleep during surgery.

Description of the Procedure

You will be connected to a ventilator. This is a machine that moves air in and out of your lungs. Depending on the reason you are having VATS, one lung will be completely or partly deflated. This will allow your doctor to have a better view of the chest cavity on that side.
Several small cuts in the skin will be made along your side. Carbon dioxide gas will be used to fill the chest cavity. The gas will make it easier for the doctor to see internal structures. Through one of the incisions, the doctor will insert the thoracoscope. This camera will send images to the TV monitors. The doctor will rely on these images to do the surgery. Other small tools will be inserted into the cuts. These tools will allow the doctor to grasp, cut, dissect, and suture.
When the surgery is done, the tools will be removed. The lung will be inflated. A chest tube will be placed to drain any air or fluid. The doctor will close the incisions with sutures or staples.

Immediately After Procedure

If you are doing well, the breathing tube will be removed. In the recovery room, the hospital staff will monitor your vital signs. You may be given fluids and medicines through an IV.

How Long Will It Take?

1-2 hours (depending on the procedure)

How Much Will It Hurt?

You will have pain after surgery. Your doctor will give you pain medicine.

Average Hospital Stay

You may be able to go home the next day. If you have VATS for a lobectomy (removal of part of the lung), the usual length of stay is 3-4 days.

Post-procedure Care

At the Hospital
While you are recovering at the hospital, you may receive the following care:
  • Fluids and pain medicine through an IV line
  • Assistance sitting up and moving around soon after surgery
  • Directions on how to do deep breathing and coughing exercises—You will learn how to use an incentive spirometer. This device helps you expand your lungs when taking a deep breath. This will prevent pneumonia .
  • Chest x-rays to monitor healing—The drainage chest tubes will be removed once your lungs are healed.
  • Instructions about nutrition and physical activity
At Home
Follow your doctor’s instructions, which may include:
  • Walk daily.
  • Take pain medicine as directed. Some pain medicine causes constipation . To prevent this, drink plenty of fluids and eat high-fiber foods.
  • Continue to use the incentive spirometer. Do deep breathing. You will also be encouraged to cough.
  • Keep the incision area clean and dry.
  • Limit certain activities until you have recovered.
Ask your doctor about when it is safe to shower, bathe, or soak in water.

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:
  • Cough or shortness of breath
  • Coughing up yellow, green, or bloody mucus
  • New chest pain
  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from an incision site
  • Difficulty urinating (eg, pain, burning, urgency, frequency, or bleeding)
  • Pain and/or swelling in your feet, calves, or legs
  • Persistent nausea, vomiting, and/or diarrhea
  • Headache, feeling faint or dizzy
  • Other worrisome symptoms
Call for medical help or go to the emergency room right away if any of the following occurs:
  • Sudden chest pain
  • Sudden shortness of breath
If you think you have an emergency, call for medical help right away.

RESOURCES

American College of Surgeons http://www.facs.org/

Society of Thoracic Surgeons http://www.sts.org/

CANADIAN RESOURCES

Canadian Lung Association http://www.lung.ca/

Health Canada http://www.hc-sc.gc.ca/index%5Fe.html/

References

A patient’s guide to lung surgery: recovering at the hospital. University of Southern California, Cardiothoracic Surgery website. Available at: http://www.cts.usc.edu/lpg-thoracoscopy-recoveringinthehospital.html . Accessed March 9, 2010.

A patient’s guide to lung surgery: recovering at home. University of Southern California, Cardiothoracic Surgery website. Available at: http://www.cts.usc.edu/lpg-thoracoscopy-recoveringathome.html . March 9, 2010.

A patient’s guide to lung surgery: when to call the doctor. University of Southern California, Cardiothoracic Surgery website. Available at: http://www.cts.usc.edu/lpg-thoracoscopy-whentocallyourdoctor.html . Accessed March 9, 2010.

Pulmonary lobectomy. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated November 2009. Accessed March 8, 2010.

Robot-assisted laparoscopic procedures. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated December 2009. Accessed March 8, 2010.

Robot-assisted thoracic procedures. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated December 2009. Accessed March 8, 2010.

Video-assisted thoracic surgery. Harvard Health Publications website. Available at: http://www.health.harvard.edu/diagnostic-tests/video-assisted-thoracic-surgery.htm . Accessed March 8, 2010.

Video-assisted thorascopic surgery (VATS). Rush University Medical Center website. Available at: http://www.rush.edu/rumc/page-1160429783340.html . Accessed March 8, 2010.

Video-assisted thoracoscopic surgery (VATS). Mayo Clinic website. Available at: http://www.mayoclinic.org/video-assisted-thoracic-surgery . Accessed March 8, 2010.

6/6/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

Revision Information

Health Library Search

Only show results from the selected categories.
1 Lower Leg Venography procedure

Venography is an x-ray test used to study the veins of the body. Lower leg venography is used to study the veins in the legs....

2 CT Scan of the Abdomen procedure

A CT scan is a type of x-ray. It uses a computer to make pictures of the inside of the body. In this case, images of the abdomen are taken....

3 Echocardiogram procedure

An echocardiogram uses sound waves called ultrasound to look at the size, shape, and motion of the heart. The test shows: In addition to this standard test, there are s...

4 Abdominal X-ray procedure

An x-ray creates pictures of organs in the body. This type of x-ray takes a picture of organs in the abdomen....

5 Renal Ultrasound procedure

This test uses sound waves to study the renal system. The renal system includes the kidneys, bladder, and ureters (the tubes that connect the kidneys to the bladder)....

6 Diagnostic Ultrasound of the Abdomen procedure

An ultrasound uses sound waves to create images of structure in the body. A Doppler ultrasound is a special type of ultrasound that can show blood flow in the vessels....

7 Dual Energy X-ray Absorptiometry procedure

Dual energy X-ray absorptiometry (DEXA) is a test that measures the density (or thickness) of your bones. The DEXA scan is an x-ray scan that uses a small amount of radi...

8 Positron Emission Tomography procedure

This test makes images that show activity in body tissues. A substance that gives off a tiny amount of radiation is put into your body. This substance goes to the part of...

9 New Dimensions in Prenatal Ultrasound: 3D and 4D lifestyle - women's health

Do you have those black and white, somewhat cryptic ultrasound photos of your little-one-to-be? Would you be interested in photos that look more like a baby? As well as i...

10 Bone Scan procedure

A bone scan is a test that detects areas of increased or decreased bone activity. These may indicate bone injury or disease. Radioactive isotopes and tracer chemicals are...

11 Doppler Ultrasound procedure

A Doppler ultrasound is a test that uses sound waves to examine parts of the body. It looks at the motion of fluids in the blood vessels....

12 Venous Duplex Ultrasound procedure

An ultrasound uses sound waves to create images of the inside of the body. A venous duplex ultrasound is an ultrasound that looks at the flow of blood through the veins i...

13 Magnetic Resonance Angiography procedure

MRA is a study of the blood vessels using magnetic resonance imaging (MRI). Using a large magnet, radio waves, and a computer, an MRA makes two-dimensional and three-dime...

14 Computed Tomography Angiography procedure

Computed tomography angiography (CTA) is a specialized x-ray that examines blood flow in blood vessels when they are filled with a contrast material. Contrast material is...

15 Chest X-ray procedure

A chest x-ray is an image of the heart and lungs and other structures in the chest. A small dose of radiation is used to create the image. It is one of the most common me...

16 Angiography procedure

An angiography is an x-ray exam of the blood vessels. The exam uses a chemical that is injected into the blood vessels. The chemical makes the blood vessels easier to see...

17 Peripheral Vascular Ultrasound procedure

Peripheral vascular ultrasound is a test used to evaluate the health of blood vessels. Ultrasound uses sound waves to capture images of structures inside the body. It is ...

18 PET/CT Scan procedure

PET/CT scan is a type of imaging test that combines positron emission tomography (PET) and computed tomography (CT) techniques. Combined PET/CT scans can be performed on ...

19 Electron-Beam Computed Tomography procedure

Electron-beam computed tomography (EBCT) is a fast and sensitive test for detecting calcium build-up in the arteries of the heart. It uses an electron “gun” instead of re...

20 Transesophageal Echocardiography procedure

Echocardiography uses sound waves (ultrasound) to make images of the heart. In transesophageal echocardiography, the ultrasound probe is passed down the throat in the eso...