Video-Assisted Thoracoscopic Surgery (VATS) is a minimally invasive technique used to diagnose and treat various chest diseases. This procedure involves inserting a thoracoscope, an endoscopic camera, through small incisions in the chest. VATS is commonly used to manage conditions like lung cancer, pleural effusion, and diaphragm disorders. It enables surgeons to operate without spreading the ribs or cutting major chest muscles, minimizing pain, blood loss, and recovery time. Performed under general anesthesia, VATS involves thorough preparation, including diagnostic tests and patient preparation. The procedure can range from biopsies to complex surgeries like tumour removal or heart valve repairs. Post-surgery, a chest tube may assist recovery by draining fluids. VATS offers benefits like reduced pain, shorter hospital stays, lower complication risks, and minimal scarring. While rare complications like infection or nerve damage may occur, careful monitoring and adherence to post-operative care ensure smoother recovery and improved outcomes.
Video-Assisted Thoracoscopic Surgery (VATS) is a minimally invasive surgical technique used both in the diagnosis and treatment of diseases in the chest cavity. The procedure uses an endoscopic camera called a thoracoscope, inserted through small incisions in the chest, to view and operate on the organs in the chest. VATS is often performed to treat lung cancer, chronic obstructive pulmonary disease (COPD), pleural effusion, spontaneous pneumothorax, pericarditis, spinal tumours, and paralysis or hernia of the diaphragm. One of the main advantages of the VATS procedure is that the surgeon can operate on important organs in the chest without spreading the ribs or cutting the surrounding muscle tissue extensively. This benefits patients by reducing post-operative pain, leading to quicker recovery and shorter hospital stays. Since the major chest muscles are not cut, patients can return to normal activity levels more quickly and do not require much rehabilitation.
Doctors use the VATS procedure in various ways to diagnose and treat diseases in the chest. This includes diseases affecting the lungs, lymph nodes, spine, heart, oesophagus and diaphragm. VATS is often used to retrieve tissue samples from thoracic tumors for biopsy. This is done to determine if tumors are cancerous or not, identify the type of cancerous tissue and plan a course of treatment accordingly. VATS may also be used to remove tumors and surrounding tissues. The procedure can even be used to remove an entire lung, or a part of it. It can also be used to drain an infected abscess in the lung and removing restrictive fibrous tissue growth over the lungs.
Heart procedures like atrial fibrillation ablation, pacemaker lead placement and mitral valve repair can also be performed using the VATS technique.
The VATS procedure is performed by a thoracic (chest) or cardiothoracic (heart and chest) surgeon. Surgeons undergo extensive training to master this technique. Before the procedure, the patient will be required to undergo a series of tests. This may include blood tests, electrocardiogram (EKG), treadmill stress test for the heart, a chest X-ray, CT scan, PET scan, pulmonary function test and an upper endoscopy. This baseline data helps the surgeon create a surgical plan. The thoracic surgeon or cardiothoracic surgeon will also advise the patient on how to prepare for the surgery. Patients will need to stop taking certain medications like blood thinners before the procedure. Patients who smoke will also be advised to quit, and provided with additional resources and help. It is also advised to exercise at a reasonable pace in the days leading up to the VATS surgery. This strengthens the lungs and improves the patient’s pre-operative fitness level. This can lead to a quicker and more comfortable recovery.
The procedure is performed under general anaesthesia. The patient will likely also be given some antibiotics to prevent infection. Once the patient is asleep, a breathing tube is placed into their airway. This is done in such a way that each lung can be inflated with air separately during the surgery. The breathing tube assists the patient in breathing during the surgery. The patient is typically positioned on their side, depending on the organ to be operated on. The surgeon will then make multiple small incisions between the ribs. The thoracoscope is inserted through one of the incisions, and provides the surgeon will real-time data about the organs being operated on. This could be the lungs, the spine, the heart or the oesophagus and the tissue surrounding them.
Once the surgeon has located and inspected the organ, the other tools for the operation are inserted through the remaining slits. The surgeon can use these tools to take a tissue sample for biopsy, remove cancerous tumors or drain fluid from around the lungs, as the case may be. Once the operation is completed, the surgeon will insert a chest tube through one of the incisions to drain the fluid or air leaking into the chest cavity and help the lungs re-inflate with air. This tube may be kept in place until the patient is discharged from the ICU.
The VATS procedure is a minimally invasive procedure and has many benefits over conventional open procedures:
Reduced Pain – VATS causes less trauma to the chest muscles and ribs. The chest muscles do not need to be cut to create a large incision, and the ribs do not need to be spread. Patients typically lose far less blood in a minimally invasive procedure.
Shorter Hospital Stay – Patients who have undergone VATS typically recover much faster compared to patients who undergo open surgery. They need shorter hospital stays, and can return to their normal routines more quickly.
Lower risk of complications – VATS doesn’t have a zero risk of complications, but the risks are significantly lower than the risks associated with open surgery.
Less scarring – Patients who undergo VATS do not have large scars on their body. They will have multiple small scars which may fade more easily with time.
Higher degree of safety – VATS can be performed on patients who are too weak for open surgery. This includes elderly people, and patients with other underlying conditions.
Although VATS is a minimally invasive, safe procedure, there are risks associated with it. This includes symptoms like fever, excessive bleeding, pneumonia, infection, nerve damage, blood clots that could lead to strokes, organ damage, heart attack, shock, post-anaesthetic complications. The patient’s age, pre-existing health conditions and post-operative care influence the patient’s risk of developing these complications. Having said that, these complications are rare. You can discuss your risk of complications with your doctor before surgery.
Most patients will need to spend a few nights in the hospital after surgery. This period is when patients are most vulnerable to complications, so they are advised to remain in the hospital where they can be monitored by skilled nurses 24/7. Once the critical period is over, the patient will be discharged and allowed to rest at home. During discharge, the patient will be given post-operative care instructions that must be followed diligently. The patient will be taught how to change their surgical dressings, be instructed on the medications to take and when, and receive guidelines on the level of activity they are allowed to engage in.
It is recommended to rest for a few days, avoid lifting heavy objects, or engaging in activities that may cause shortness of breath. If you experience chest pains, difficulty breathing, or notice any redness, swelling, or pus at the incision site, inform your doctor immediately.
The long-term outlook after VATS varies from patient to patient. Your doctor can educate you on the long-term results you can expect based on your unique diagnosis and baseline health.
If you require advanced chest or lung surgery, expert care is available at Kauvery Hospital. With branches in Chennai, Hosur, Salem, Tirunelveli, and Trichy, our skilled thoracic surgeons specialize in minimally invasive procedures like VATS, ensuring the best possible outcomes and faster recovery for our patients.
VATS, or Video-Assisted Thoracoscopic Surgery, is used to diagnose and treat conditions inside the chest such as lung cancer, pleural effusion, diaphragm disorders, and chest infections. It allows surgeons to operate through small incisions using a camera for better precision and faster recovery.
Yes, VATS is a major surgical procedure but performed using a minimally invasive approach. It involves smaller incisions and less trauma than traditional open-chest surgery, which means reduced pain and a shorter hospital stay.
Most patients recover within 2–4 weeks, depending on the type of surgery and their overall health. You may need to stay in the hospital for a few days after surgery for observation and chest tube management.
Yes, VATS is considered safer for elderly patients compared to open surgery. Since it causes less pain, blood loss, and strain on the body, it’s often recommended for patients who may not tolerate open procedures well.
While rare, complications such as bleeding, infection, nerve injury, or pneumonia can occur. Following post-surgery instructions and regular monitoring helps reduce these risks and ensures smoother recovery.
Yes, VATS can be used for several heart and lung-related procedures, including lung biopsies, tumour removals, draining fluid collections, and even certain heart valve repairs.
Your doctor will advise stopping certain medications, avoiding smoking, and undergoing diagnostic tests before surgery. Staying active and maintaining good lung health before surgery can also help improve recovery outcomes.
No large scars are left behind. The procedure uses 2–4 small incisions, each just a few centimetres long. These usually heal well, leaving minimal scarring over time.
Light activities can usually be resumed within a few days, but heavy lifting or strenuous exercise should be avoided for at least 3–4 weeks. Your doctor will guide you based on your recovery progress.
VATS has a high success rate with fewer complications and quicker recovery than open-chest procedures. Outcomes depend on the underlying condition and patient health but are generally excellent.
Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai (Alwarpet, Vadapalani & Radial Road), Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and paediatric trauma care.
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