When a doctor tells you or someone you know that you need to have "chest surgery," it's normal to feel a little scared. The thought of "major surgery that will remove the chest" is what comes to mind. But today, medical science has advanced a lot. That's why there is now a "keyhole surgery" method to treat many diseases of the chest, which is done through small holes without making such large incisions. That's what we call VATS.
What exactly is VATS?
VATS stands for Video-Assisted Thoracic Surgery . Simply put, it is a surgery performed inside the chest cavity with the help of a video camera. "Thoracic" refers to the part of the chest between our neck and stomach. This area is where many important organs like our heart, lungs, and esophagus are located.
Imagine... In this surgery, instead of making a large incision in your chest, the doctor makes a very small incision between two of your ribs and inserts a thin tube with a small camera (we call this a thoracoscope ) through it. The images from this camera are shown on a large screen (monitor). Then, one or two more small incisions are made and the delicate instruments needed for the surgery are inserted through them. Now the doctor can look at the images on that screen and treat the problem inside the chest very precisely.
This is a minimally invasive surgery. This means that the damage to the body, scarring, and pain are much less than traditional surgeries.
In what cases is VATS surgery necessary?
VATS is primarily used to diagnose and treat lung cancer and metastatic cancer, but it is also used for many other conditions.
| Medical condition | A simple explanation |
|---|---|
| Lung Cancer | To identify a cancerous tumor (biopsy) or to remove it. |
| Cancer of the esophagus or thymus gland | To treat cancers in these organs. |
| Pleural Effusion | In cases of fluid accumulation around the lungs, find the cause and remove the fluid. |
| Lung diseases such as COPD | In chronic lung diseases, to remove damaged lung parts. |
| Hyperhidrosis | As a treatment for excessive sweating. |
| Myasthenia Gravis | To remove the thymus gland in this disease that weakens the muscles. |
Main types of VATS surgeries
- VATS lung resection: This involves removing a diseased part of a lung. A small piece (`wedge resection`), a whole lobe (`lobectomy`), or possibly the entire lung (`pneumonectomy`) may be removed.
- Esophagectomy: Removal of a diseased part of the esophagus.
- Thymectomy: Removal of the diseased thymus gland.
- Decortication: Removal of infected membranes or scar tissue that surround the lungs.
How should I prepare before surgery?
This is very important. You must follow your doctor's instructions exactly .
- You will be asked to fast (abstain from eating or drinking) for a few hours before the surgery.
- You may be asked to temporarily stop taking certain medications, vitamins, and herbal products.
- If you are a smoker, you definitely need to stop .
- In addition, several tests may be ordered before surgery, such as:
- Blood tests - for example, a complete blood count (CBC).
- Tests that check the functioning of the heart - like an ``(EKG)``.
- Imaging tests such as chest X-ray, CT scan, or PET scan.
- Pulmonary function testing.
- Tests such as `Upper Endoscopy`.
What are the benefits and risks of this surgery?
There are benefits and risks to any surgery, but VATS surgery has more benefits and fewer risks than traditional open surgery (`thoracotomy`).
| Benefits | Risks |
|---|---|
| There is less time to spend in the hospital. | Heartbeat irregularities (Arrhythmias). |
| There is less pain and scarring after surgery. | Blood clot or stroke. |
| The respiratory process quickly returns to normal. | Pneumothorax. |
| The risk of infection is low. | Internal bleeding or infections. |
| You can return to normal activities quickly. | Respiratory problems such as pneumonia. |
What happens after the surgery? How long does it take to recover?
After the surgery, you will be in the hospital for one or two days. During this time:
- You will be given medication to control the pain .
- Encourage deep breathing exercises and walking. This will reduce the risk of complications.
- The chest tube inserted during surgery will be removed before you go home.
The recovery time depends on the type of surgery you had. It may take two weeks to fully recover. Sometimes it can take up to eight weeks . After you go home, it is very important to follow your doctor's instructions carefully.
- Change dressings on cuts as needed.
- Avoid lifting weights.
- Avoid driving and going to work until the prescribed time.
- Take the medicine exactly as prescribed by the doctor.
- Walk at least three times a day to prevent blood clots in your legs.
What are the symptoms that require you to call your doctor immediately?
If you develop any of these symptoms after you go home, you should notify your doctor immediately .
- Severe chest pain
- Difficulty breathing
- The incision becomes red, swollen, or has a yellow discharge.
- Fever
Receiving a diagnosis of cancer is a difficult time for anyone. At a time like this, any relief from treatment is a big deal. VATS is a modern method that is less painful and allows for a faster recovery than open surgery. Your doctor will explain to you whether this is right for you. Feel free to ask your doctor any questions you may have.
Take-Home Message
- VATS is a "keyhole surgery" technique used to treat diseases of the chest cavity.
- Since there are no large incisions, there is less pain, scarring, and time spent in the hospital.
- This method is used to treat a number of chest diseases, including lung cancer.
- It is essential for a speedy recovery to follow the doctor's instructions carefully before and after surgery.
- If you experience any unusual symptoms (chest pain, difficulty breathing) after surgery, seek medical advice immediately.
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