Video-Assisted Thoracic Surgery (VATS)

In the past, surgeons performed lung surgeries through an open thoracotomy approach, making large incisions of approximately 8 to 20 centimeters. The size of the incision depended on the type of surgery performed and coupled with applying a rib spreader to enlarge the physical access to the operative field. This approach invariably led to significant postoperative pain and increased susceptibility to complications.

Currently, there have been significant advancements in surgical equipment and techniques. Video-assisted thoracic Surgery (VATS) is now often employed for lung surgeries, allowing for smaller incisions. Surgeons utilize this minimally invasive procedure in treating diseases within the chest cavity. Research from various medical institutions has confirmed that VATS yields outcomes comparable to or even superior to traditional open surgeries. The associated side effects and complications are reduced because patients experience less postoperative pain, have shorter hospital stays, and generally achieve a quicker recovery.

In the pioneering days of VATS, surgeons relied on making 3-4 small incisions in the chest to access the lungs and mediastinum. As they accumulate more experience with this approach, the trend has shifted towards minimizing the number and size of incisions, and with the advancement of surgical techniques and the development of more sophisticated equipment, surgeons now commonly employ a technique known as uniportal VATS, which involves performing the entire procedure through a single incision, typically measuring only 2-3 centimeters, further enhancing the benefits of reduced trauma, quicker recovery, and improved cosmetic outcomes for patients undergoing thoracic surgeries.

Disorders treatable with VATS

• Eary-stage lung cancer (Stage 1 or 2)
• Pulmonary nodule
• Pneumothorax
• Pleural infection
• Tumors in the mediastinum, such as thymoma

Types of lung disorders VATS is suitable for

Lung surgery using VATS is suitable for treating various types of lung diseases. If the surgeon specializes in endoscopic surgery and the hospital employs state-of-the-art surgical tools, over 90% of patients with lung diseases can be effectively and safely treated using the minimally invasive approach of small-incision video-assisted thoracic surgery.

The steps of lung surgery using VATS

The surgical procedure using the minimally invasive technique of video-assisted thoracic surgery typically begins with administering anesthesia to the patient to induce sedation, rendering them unaware during the surgery. The overall duration of the surgery is approximately 1-2 hours. After the procedure, a chest tube is usually inserted to help drain fluid and blood from the chest cavity.

Patients may require postoperative observation in an intensive care unit (ICU) for a brief period, although the duration depends on the attending physician’s discretion. In most cases, this observation period does not exceed one day. Patients are then moved to a standard ward for an additional 1-3 days of recovery. The overall hospitalization duration is contingent on factors such as the complexity of the surgery, the patient's recovery progress, and the occurrence of any complications.

What are the complications of video-assisted surgery, and are they dangerous?

Surgery conducted with video-assisted techniques is considered a highly safe procedure. The mortality rate associated with this type of surgery is less than 1%, and the likelihood of complications is less than 5% for patients undergoing video-assisted surgery.

Potential complications include postoperative air leakage, atelectasis, and lung infections. In open thoracotomy surgery, most complications stem from severe postoperative pain. The innovation of performing surgery using video-assisted techniques has significantly contributed to minimizing postoperative pain, resulting in fewer complications when compared to open surgeries. Complications typically arise more frequently in high-risk groups, such as elderly patients, those with underlying lung conditions, or individuals with multiple comorbidities. Video-assisted surgery is considered safer and more beneficial in treating high-risk patients.

After the surgery, close monitoring and pain management are crucial aspects of postoperative care. Physical therapy is provided to help patients assist themselves and reduce the chance of other potential complications. This approach ensures a comprehensive recovery and minimizes postoperative challenges.

Can patients return to normal activities after undergoing VATS?

Patients typically return to normalcy after surgery if there are no severe complications. Patients may experience mild pain at the incision site, numbness or tingling sensation in the chest area, increased fatigue, occasional coughing with minimal phlegm, or occasional mixed with some blood within the initial 1-2 weeks following surgery. These side effects are typically harmless and often resolve without treatment within 2-4 weeks after surgery. After this recovery period, patients can typically resume work, engage in physical activities, and carry out their daily routines as usual.

FAQ

• What is video-assisted thoracic surgery?
  Lung surgery using the minimally invasive approach of small-incision video-assisted thoracic surgery (VATS) involves treating diseases within the chest cavity with a thoracoscope. In this approach, surgeons make a single incision, typically measuring 2-3 centimeters. This surgical procedure, known as Uniportal VATS, causes minimal patient complications, less postoperative pain than traditional surgery, shorter hospital stays, and a quicker recovery.
• What disorders are treatable with VATS?
  Diseases that are treatable with the minimally invasive technique of small-incision video-assisted thoracic surgery include early-stage lung cancer (Stages 1 and 2), lung nodules, pneumothorax (air leakage in the pleural cavity), pleural infections, and mediastinal tumors, such as thymoma.
• Can patients return to normal activities after surgery?
  Patients will undoubtedly return to normalcy after surgery, provided no severe complications develop. Mild pain at the incision site, numbness or tingling sensation in the chest area, increased fatigue, and occasional coughing with minimal phlegm and blood may occur within the initial 1-2 weeks following surgery. These side effects are non-threatening and typically resolved on their own. After this recovery period, patients can generally resume work, engage in physical activities, and carry out their daily routines as usual within 2-4 weeks post-surgery.