Video Assisted Thoracoscopic Surgery (VATS)

In this surgery, a small camera and surgical instruments are inserted in the chest through a small opening in the ribs. VATS enables surgeons to diagnose and treat illnesses or injuries in the chest area using minimum incisions. A tiny camera is let in through the incision along with small surgical instruments. The camera called the thorascope, generates images which are transmitted to the numerous video screens for the surgeons to analyze. This procedure induces a pneumothorax similar to a pleuroscopic procedure for a clear view of the operated area. In case of lung cancer, the tumor is removed by the use of special equipment, which makes the operation less painful and quickens recovery. The field has evolved a lot and now incorporates laparoscopic features as a routine process for general surgeons.

The Test

The VATS method enables the surgeons to independently operate the bulky mass on the fringes of the lungs with lesser ramifications. In conventional thoracotomy, doctors needed more time and it demanded a complex method involving the tearing up of a large area. This translated into more effort and risk. It can also be used in diagnostic capacity for detecting pneumonia, treatment of collapsing lungs and minor infections of the chest walls. With the passage of time, many abnormalities are being detected using this procedure. The test follows a set of predefined steps to be followed before the surgery. A registered medical practitioner, who is a surgeon or a trained pulmonary specialist can handle the VATS procedure.

The general precautions taken before this surgery are the same as any operation. Pulmonary function tests, or existing medications like insulin, anti-inflammation drugs or blood clotting medicine intake requires prior examination by a doctor, before the test. A meeting with the anesthesiologist before going through the procedure is a mandatory step. The surgery is performed in an operating room and begins with the placing of an intravenous line in the arm for medications. A tube facilitates breathing, a nasogastric tube drains the stomach and a catheter is put in the bladder to drain urine. In order to insert the various tubes, an anesthetic consisting of a mixture of gases is administered to the patient. In some cases, only one of the lungs is open for breathing, while the other is deflated for a clear view of the chest cavity, on the side being operated on.

For the entire duration of VATS, the patient rests on one side. Two small openings or incisions are made in between the ribs; one of them, to let the camera in and the other to insert surgical instruments. The size of the opening varies according to the size of the region being operated upon and the ambit of the operation. Once the procedure is completed, the instruments are removed, the lung is inflated again and all incisions are closed, except one. The remaining opening helps drain any leakage or fluid filled lungs, by inserting a chest tube through it.

Operations involving comparatively lesser complicated steps, like pleural biopsies, pleurodesis or pulmonary decortication, commonly employ VATS. Technically demanding procedures are performed only at specialized centers using VATS, although its application is becoming common with each passing day. Surgeons who have performed VATS, swear by its applicability and preference over other forms of treatment.