by Stahl RJ

Video-Assisted Thoracic Surgery



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 , including lymph node biopsy.
  • 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
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 or collapsed lung.
  • 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:
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 ).
  • 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.


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
  • Pain and/or swelling in your feet, calves, or legs
  • Persistent nausea, vomiting, and/or diarrhea
  • 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.


American College of Surgeons

Society of Thoracic Surgeons


Canadian Lung Association

Health Canada


A patient’s guide to lung surgery: recovering at the hospital. University of Southern California, Cardiothoracic Surgery website. Available at: Accessed March 9, 2010.

A patient’s guide to lung surgery: recovering at home. University of Southern California, Cardiothoracic Surgery website. Available at: March 9, 2010.

A patient’s guide to lung surgery: when to call the doctor. University of Southern California, Cardiothoracic Surgery website. Available at: Accessed March 9, 2010.

Pulmonary lobectomy. EBSCO Health Library website. Available at: Updated November 2009. Accessed March 8, 2010.

Robot-assisted laparoscopic procedures. EBSCO Health Library website. Available at: Updated December 2009. Accessed March 8, 2010.

Robot-assisted thoracic procedures. EBSCO Health Library website. Available at: Updated December 2009. Accessed March 8, 2010.

Video-assisted thoracic surgery. Harvard Health Publications website. Available at: Accessed March 8, 2010.

Video-assisted thorascopic surgery (VATS). Rush University Medical Center website. Available at: Accessed March 8, 2010.

Video-assisted thoracoscopic surgery (VATS). Mayo Clinic website. Available at: Accessed March 8, 2010.

6/6/2011 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.

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....

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....

4 Arteriogram procedure

An arteriogram is a test that allows a doctor to see the arteries on an x-ray . A contrast dye is injected into the arteries to make them visible. The test makes images t...

A CT scan uses x-ray technology to take multiple views of the inside of the body. Compared to regular x-rays, a CT scan can take clearer and more detailed images of organ...

7 X-ray procedure

X-rays use a small dose of radiation to create pictures of the inside of the body....

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

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 regu...

10 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 ...

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 ...

12 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...

13 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...

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...

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...

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...

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....

18 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...

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...

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...