Definition
A video-assisted thoracic surgery (VATS) is when a doctor uses a tiny camera (thoracoscope) and small incisions to do surgery inside the chest. Images from the camera are sent to TV monitors to help guide surgery.
Reasons for Procedure
This surgery may be done to:
- Diagnose and treat lung cancer, such as with a lymph node biopsy
- Remove diseased lung sections or lobes
- Diagnose lung infections
- Treat a collapsed lung
- Drain fluid out of the chest cavity
- Diagnose and treat problems with the thymus gland
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The benefits of this type of surgery are:
- Less scarring
- Less trauma to the body
- Faster recovery
- Less time in the hospital
Possible Complications
Problems from robotic-assisted surgeries are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Infection
- Collection of air or gases in the lung cavity
- Collapsed lung
- Damage to nearby organs or structures
- The need to switch to open surgery
Things that may raise the risk of problems are:
- Smoking
- Chronic diseases, such as diabetes or obesity
- Alcohol use disorder
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Arranging for a ride to and from surgery
- Tests that will need to be done before surgery, such as lung function tests and imaging
Anesthesia
General anesthesia will often be used. You will be asleep with general anesthesia.
Sometimes the doctor may be able to use nerve blocks or epidural anesthesia. Pain will be blocked in the area but you will be awake.
Description of the Procedure
You will be connected to a machine that will help you breathe. Depending on the surgery you are having, one lung will be fully or partly deflated. This will help the doctor view the area better.
Several small incisions will be made along your side. A needle will be used to inject gas into the chest cavity. This will make it easier to see inside the body. A scope with a small camera on the end will be passed through one of the incisions. The camera will display the area on a video screen. Other small tools will be inserted into the other incisions to do the surgery.
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. They will be covered with bandages.
How Long Will It Take?
About 1 to 2 hours. It depends on the type of surgery.
Will It Hurt?
It depends on the surgery, but pain and swelling are common in the first 2 weeks. Medicine and home care can help.
Average Hospital Stay
The usual length of stay is a one day, but it depends on the reason for surgery. If you have any problems, you may need to stay longer.
Post-procedure Care
At the Hospital
Right after the procedure, the staff may:
- Give you medicine to treat pain
- Teach you how to do deep breathing and coughing exercises
During your stay, staff will take steps to lower your chance of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
You can also lower your chance of infection by:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others touch your incisions
At Home
Activities will be limited during recovery. You may need to ask for help with daily activities and delay your return to work. It will take a few weeks to heal.
Call Your Doctor
Call the doctor if you are not getting better or you have:
- Signs of infection, such as fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from an incision
- Been coughing up yellow, green, or bloody mucus
- Cough or shortness of breath
- New chest pain
- Pain and/or swelling in your feet, calves, or legs
- Lasting nausea, vomiting, or diarrhea
- New or unexpected symptoms
If you think you have an emergency, call for medical help right away.
RESOURCES:
American Thoracic Society
http://www.thoracic.org
The Society of Thoracic Surgeons
https://www.sts.org
CANADIAN RESOURCES:
Canadian Society for Vascular Surgery
https://vascular.ca
The Lung Association
https://www.lung.ca
REFERENCES:
Davies HE, Davies RJ, et al. Management of pleural infection in adults: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010 Aug;65 Suppl 2:ii41-53.
Parapneumonic effusion and empyema in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/parapneumonic-effusion-and-empyema-in-adults. Accessed August 18, 2020.
Post-operative minimally invasive (robotic or thoracoscopic) lung surgery instructions. University of Southern California Division of Surgery website. Available at: http://www.surgery.usc.edu/thoracic/downloads/usc-minimally_invasive_lung_surgery_january2017.pdf. Accessed August 18, 2020.
Video-assisted thoracic surgery. Harvard Health Publications website. Available at: https://www.health.harvard.edu/diagnostic-tests/video-assisted-thoracic-surgery.htm. Accessed August 18, 2020.
Video-assisted thorascopic surgery (VATS). Rush University Medical Center website. Available at: https://www.rush.edu/services/test-treatment/video-assisted-thoracoscopic-surgery-vats. Accessed August 18, 2020.
Last reviewed March 2021 by EBSCO Medical Review Board James P. Cornell, MD Last Updated: 8/18/2020