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 a collapsed lung—atelectasis
- Draining fluid out of the chest cavity
- Diagnosing and treating of the thymus gland
Compared to traditional procedures, VATS may result in:
- Less pain and faster recovery
- Shorter hospital stay
- Fewer complications
- Less scarring
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Anesthesia-related problems
- Air leaking from the lungs or collapsed lung.
- Chest pain
- The need to switch to open chest surgery
Some factors that may increase the risk of complications include:
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
- Tests to evaluate how well the heart is functioning
Leading up to the surgery:
- Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
- Arrange for someone to drive you home.
- Arrange for help at home during your recovery.
- Eat a light meal the night before. Do not eat or drink anything after midnight.
General anesthesia will be given—you will be asleep during the procedure
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 medications through an IV.
How Much Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
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.
At the Hospital
While you are recovering at the hospital, you may receive the following care:
- 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.
- Chest x-rays to monitor healing—The drainage chest tubes will be removed once your lungs are healed.
- Instructions about nutrition and physical activity
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as:
- Washing your hands often and reminding your healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incision
Call Your Doctor
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
- 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
- New or worsening symptoms
Call for emergency medical services right away for:
- Sudden chest pain
- Sudden shortness of breath
If you think you have an emergency, call for medical help right away.
American Thoracic Society
The Society of Thoracic Surgeons
Canadian Society for Vascular Surgery
The Lung Association
A patient’s guide to lung surgery: Recovering in the hospital. University of Southern California Cardiothoracic Surgery website. Available at: http://www.cts.usc.edu/lpg-thoracoscopy-recoveringinthehospital.html. Accessed February 2, 2015.
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. Accessed February 2, 2015.
A patient’s guide to lung surgery: When to call your doctor. University of Southern California Cardiothoracic Surgery website. Available at: http://www.cts.usc.edu/lpg-thoracoscopy-whentocallyourdoctor.html. Accessed February 2, 2015.
Video-assisted thoracic surgery. Harvard Health Publications website. Available at: http://www.health.harvard.edu/diagnostic-tests/video-assisted-thoracic-surgery.htm. Updated August 11, 2014. Accessed February 2, 2015.
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/tests-procedures/video-assisted-thoracic-surgery/basics/definition/prc-20021362. Updated May 8, 2014. Accessed February 2, 2015.
6/6/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
Last reviewed February 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.