Video-Assisted Thoracoscopic Surgery (VATS)

What is video-assisted thoracoscopic surgery (VATS)?

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

In VATS, a tiny camera called a thoracoscope and surgical instruments are inserted into the chest through one or more small incisions.

The thoracoscope transmits images onto a video monitor to guide the surgeon in performing the procedure.

Compared with traditional surgery, minimally invasive surgery such as VATS offers benefits such as:

• Decreased postoperative pain
• Less bleeding
• Reduced risk of infection
• Shorter hospital stay
• More rapid recovery and return to work

Why do you need VATS?

VATS is used to to treat a wide variety of conditions involving the thorax (chest).

Some uses for VATS include:

• Biopsy for lung cancer, mesothelioma and other chest cancers
• Lung surgery for cancer and lung volume reduction surgery
• Removing excess fluid (pleural effusion) or air from the area between the lungs and chest wall
• Minimally invasive heart procedures such as atrial fibrillation ablation, pacemaker lead placement, and mitral valve repair
• Treating hyperhidrosis (excessive sweating)
• Many other surgeries that involve the heart, ribs, spine, oesophagus and diaphragm

Who should not undergo VATS?

In general, because VATS is a minimally invasive technique, it is a preferred option to traditional open surgeries.

However, VATS may not be appropriate for people who have had chest surgery previously.

Your doctor will carefully evaluate the best and safest surgery for your medical condition.

What are the risks and complications of VATS?

This procedure is generally considered safe and effective.

Like all surgical procedures however, there are some general risks, such as:

• Air leak
• Partial collapsed lung (atelectasis)
• Abnormal heart rhythms
• Excess bleeding
• Infections such as pneumonia
• Blood clots
• Shock
• Anesthesia-related effects

How do you prepare for VATS?

Before the operation, your doctor will review your medical history. You may also undergo some scans and tests such as:

• Blood tests
• Chest X-ray or CT scan
• Pulmonary function test (breathing test)
• Electrocardiogram (ECG)

Once your operation is scheduled, your doctor will advise you on how to prepare. In general, you need to fast before the procedure.

Note: If you are taking any medication or herbal supplements, you should inform your doctor. You may need to adjust or stop taking some medication before the procedure (e.g. aspirin, blood thinners).

What can you expect in VATS?

VATS is performed under general anaesthesia.

Estimated duration

The procedure lasts about 1 – 2 hours. Depending on the extent of the surgery, it may take longer.

During the procedure

During VATS, your surgeon will make several small cuts on the chest wall in which to insert the thoracoscope and surgical instruments.

After the procedure

Depending on the extent of the procedure and your condition, you may stay in the hospital for a few days.

Post-operative pain is normal and will be managed with medication.

As soon as you are able, you are advised to stand and walk to aid in the recovery process. You may also be asked to use a device that encourages you to breathe deeply to prevent an infection from developing.

Compared with a traditional open operation (thoracotomy), video-assisted thoracoscopic surgery typically results in less pain, fewer complications and shortened recovery time.