Video-Assisted Thoracic Surgery (VATS)

Video-assisted thoracic (tho-RASS-ik) surgery (VATS) is a way to look at the lungs and other tissue. A doctor puts a tiny telescope and surgical tools through small openings in the chest. The telescope is connected to a video camera that lets the doctor see a picture of the lungs. The doctor can take out small pieces of tissue during VATS. The patient may have to stay in the hospital for 1 to 3 days after surgery.

VATS has advantages over a thoracotomy (thor-o-KOT-o-mee). In a thoracotomy, the doctor makes a large opening in the chest and spreads the ribs apart. The openings made for VATS are smaller, which means less pain and fewer complications. Patients usually leave the hospital sooner after VATS than after a thoracotomy.

Before Surgery

You may have to stop taking certain medicines, such as aspirin, ibuprofen, or blood thinners before you come in for VATS. Tell your doctor or nurse about any medicines you are taking, including home remedies, vitamins, herbs, and over-the-counter drugs. Do not eat or drink anything after midnight the day before your surgery.

During Surgery

Before surgery begins, you will be given general anesthesia through an IV. When you are asleep, a tube is put into your wind pipe to help you breathe. A catheter is put into your bladder to drain urine. An NG (nasogastric) tube is placed through your nose or mouth into your stomach to drain it. The doctor makes 2 or more openings in the skin of your chest. He or she puts the small telescope through 1 opening and surgical tools through the others. The sites and size of your incisions depend on the location and size of the area being worked on.

When the surgery is done, the telescope and surgical tools are taken out. A chest tube is usually left in the incision to drain fluid or air. The incisions are closed with stitches. The operation usually takes 1 to 2 hours. The breathing tube and NG tube are taken out in the operating room before you go to the recovery room.

After Surgery

Once your surgery is finished, you are taken to a recovery room. A nurse checks your pulse, blood pressure, and oxygen levels often. You will wake up with a chest tube connected to a drainage machine. There will be bandages over your incisions and around the tube. When you are fully awake, you will go to your hospital room.

Patients have different amounts of pain after VATS. You will be given pain medicine. It is important not to be in a lot of pain so you can breathe deeply, cough, and get out of bed and start walking as soon as you are allowed. This helps to prevent pneumonia.

You will have an incentive spirometer (spy-ROM-eh-ter). An incentive spirometer is a hand-held machine that shows you how well you are expanding your lungs during deep breathing exercises. You need to do deep breathing exercises about every 2 hours while awake. Deep breathing helps the lungs expand and prevents pneumonia. You will have chest x-rays often to make sure your lungs are healing.

Once your lungs have healed, your chest tube is taken out. At that time, you may be ready to leave the hospital.

After You Leave the Hospital

At home, you will have some pain. Take your pain medicine as your doctor directs. Pain medicine can make you constipated. Drink a lot of fluids and add more fiber in your diet, unless your doctor tells you otherwise. If you are constipated, your doctor may suggest a stool softener or laxative.

It is normal for the skin below and in front of the incisions to be numb. This is because some of the nerves were cut during surgery. Numbness may last up to
6 months after surgery. Your doctor will tell you how to check and care for your incisions.

Being active when you are able helps you gain strength, feel better, and expand and heal the lungs. You will get specific activity directions. Keep using your incentive spirometer and do a lot of deep breathing and coughing. Follow the instructions your doctor gives you when you leave the hospital.

Related UPMC Patient Education Resources

Go to the category “Surgery.”

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