Video-Assisted Thoracoscopic Surgery (Vats): Causes, Symptoms, Treatment and Cost

VATS is a minimally invasive surgical treatment used to identify and treat disorders impacting the organs of the chest, including the lungs, heart, oesophagus, and diaphragm.

• Wedge Resection: This type of VATS procedure is used to remove a small section of the lung affected by cancer or other disease. The surgeon will make a few small incisions in the chest wall and then use a camera and specialised instruments to remove the diseased tissue.
• Lobectomy: This procedure is used to remove an entire lobe of the lung, either due to cancer or other disease. The surgeon will make several small incisions in the chest wall, then use a camera and specialised instruments to remove the lobe of the lung that is affected.
• Pneumonectomy: This procedure is used to remove an entire lung, either due to cancer or other disease. The surgeon will make several small incisions in the chest wall, then use a camera and specialised instruments to remove the entire lung that is affected.
• Pleurectomy/Decortication: This procedure is used to remove scar tissue from around the lungs caused by infection or inflammation, such as mesothelioma or tuberculosis (TB). The surgeon will make several small incisions in the chest wall, then use a camera and specialised instruments to scrape away scar tissue from around both lungs.
• Thoracic Sympathectomy: This procedure is used to treat hyperhidrosis (excessive sweating) by cutting nerves in your thoracic cavity that control sweating on your hands and face. The surgeon will make several small incisions in your chest wall, then use a camera and specialised instruments to cut these nerves so that you no longer sweat excessively on your hands and face

The following are the key advantages of Video-assisted Thoracoscopic Surgery (VATS):

• Reduced Risk: VATS eliminates the need for large incisions in the chest wall which can lead to decreased risk of infection, bleeding, and other complications associated with open surgery.
• Shorter Recovery Time: VATS requires only small incisions which results in shorter recovery times compared to traditional open thoracotomy surgeries. Patients are typically able to return home within 1-2 days after surgery compared to 7-10 days for an open thoracotomy procedure.
• Less Pain: Because only small incisions are made during VATS procedures, patients experience less pain than with traditional open thoracotomy surgeries which involve larger incisions that can be more painful during healing time.
• Improved Visualisation: The use of video technology during VATS allows surgeons to have improved visualisation of structures inside the chest cavity which can result in better outcomes for patients undergoing these procedures.

• Video-assisted thoracoscopic surgery (VATS) can be used to determine and treat a range of ailments, such as lung cancer, pleural effusions, pneumothorax, esophageal problems, mediastinal masses, and others.
• VATS has both therapeutic and diagnostic applications. The main benefit of VATS is that it allows surgeons to access the chest cavity without having to make large incisions or open the chest wall as in traditional open surgery.
• This results in less pain for patients, faster recovery times, fewer complications from surgery, lower risk of infection or bleeding from large incisions, and improved cosmetic results.

The risks associated with Video-assisted Thoracoscopic Surgery (VATS) include:

• Infection
• Bleeding
• Injury to the surrounding organs or tissues
• Reaction to anaesthesia
• Blood clots
• Collapsed lung (pneumothorax)
• Air leaks from the lung (pneumomediastinum)
• Damage to the nerves in the chest wall or diaphragm, resulting in pain and/or paralysis of these muscles.

• Before undergoing Video-assisted Thoracoscopic Surgery (VATS), your doctor will discuss the procedure with you and explain what to expect.
• Your doctor will inquire about your medical history, including any drugs you are currently taking and any known sensitivities.
• You may also need to undergo certain tests, such as blood work or imaging scans, prior to the procedure.
• Additionally, you should inform your physician if you are pregnant or breastfeeding, since VATS is not advised during these periods.
• You should not consume anything after midnight on the night before surgery.
• It is essential that the patient's stomach be empty throughout the surgery so that anaesthetic may be delivered properly.
• On the day of surgery, it’s important to wear comfortable clothing and remove all jewellery and other items from your body before arriving at the hospital or surgical centre.
• It’s also important that someone accompanies you who can drive you home afterwards.

• The surgeon makes small incisions in the chest and inserts a thoracoscope, which is a thin tube with a camera attached, to visualise the inside of the chest.
• The surgeon uses instruments inserted through the other incisions to remove tissue or perform other procedures as needed.
• The thoracoscope and equipment are withdrawn and the incisions are closed after the treatment is complete.
• The patient is subsequently sent to the recovery room where they will be watched until they regain consciousness.

• Preoperative evaluation: A thorough preoperative evaluation is essential to ensure that the patient is a good candidate for VATS.
• Patient education: The patient should be educated on the procedure, including potential risks and benefits, so that they can make an informed decision about whether to proceed with the surgery.
• Preparation: The patient should be prepared for the procedure by fasting for at least 8 hours prior to surgery and refraining from smoking or drinking alcohol 24 hours before the procedure.
• Anaesthesia: An anesthesiologist will administer general anaesthesia for VATS procedures to ensure that the patient remains asleep throughout the procedure and does not experience any pain or discomfort during it.
• Positioning: The patient will be placed in a lateral decubitus position with their arms tucked away from their chest in order to provide adequate access to the surgical area of interest.

• Accessing the Chest Cavity: A small incision is made in between two ribs near where the surgeon wants to access inside of the chest cavity in order to insert a thoracoscope (a thin tube with a camera). This incision is usually no bigger than 1 cm long and does not require sutures afterwards as it closes on its own over time due to natural healing processes within our bodies!
• Visualisation of Internal Structures: Once inside, images from inside of our body are projected onto a monitor so that our surgeon can visualise different structures such as lungs, heart, diaphragm etc… This allows them to assess any abnormalities present within these organs and plan out how they will go about performing their surgery!
• Surgical Instruments Insertion: Small instruments such as scissors or forceps are then inserted through additional small incisions near where our thoracoscope was inserted into our body in order for us surgeons can manipulate tissues or remove any growths present within these organs (i.e biopsy).
• Closure & Recovery: Once all of our procedures have been completed successfully our surgeon will close up all incisions using sutures (stitches) and then we are taken into recovery where we will stay until we have fully recovered from anaesthesia!

• Close the incisions: The chest surgeon will close the incisions with sutures and/or surgical staples.
• Monitor the patient: The patient will be watched for symptoms of problems, like infection and bleeding.
• Administer antibiotics: Antibiotics may be prescribed to help prevent infection.
• Provide pain relief: Pain medication may be prescribed to help manage any discomfort caused by the procedure.
• Follow-up visits: It's important to go to all of your follow-up appointments with your doctor to make sure that your recovery is going as planned and that you don't need any more treatment.

In India, the price of Video-assisted Thoracoscopic Surgery (VATS) varies based on the kind of surgery and the hospital where it is done.

Most of the time, VATS costs between Rs. 15,000 and Rs. 1 lakh in India.

Eating well is essential after undergoing VATS, so be sure to take care of yourself.

Consume large quantities of veggies and fruits, lean proteins, whole grains, and good fats.

Additionally, consuming a lot of water may aid in the healing process.

Eating soft foods such as mashed potatoes or oatmeal can also be beneficial during the recovery period.

• Yes, The procedure is generally considered safe when performed by an experienced surgeon.
• Overall, VATS is a safe alternative to traditional open-chest surgery.
• There are, however, potential complications, as with any kind of medical treatment.

• Although VATS is considered less invasive than traditional open surgery, it still carries some risks.
• Like any surgical procedure, VATS may cause some pain.
• However, studies have shown that patients who undergo VATS typically experience less postoperative pain than those who undergo open surgery.
• Additionally, patients who receive local anaesthesia during their procedure typically experience even less pain after their surgery.

The duration of time needed to recover after Video-assisted Thoracoscopic Surgery (VATS) is determined by the level of severity of the operation and the patient's current state of health.

Generally, most patients can expect to return home within a day or two after surgery and to resume normal activities within a few weeks.

In some cases, such as when major lung resections are performed, it may take up to four weeks for a full recovery.

The most common side effects of Video-assisted Thoracoscopic Surgery (VATS) include pain, soreness, and discomfort at the incision site; chest wall stiffness; temporary difficulty breathing; and a temporary decrease in lung capacity.

Other potential side effects may include infection, bleeding, air leakage from the lung into the chest cavity (pneumothorax), collapsed lung (atelectasis), nerve damage, and blood clots. In rare cases, the procedure may cause injury to other organs such as the heart or oesophagus.

• Patients should also keep an eye out for any signs of infection or complications, such as fever, chest pain, or shortness of breath. If these symptoms occur, they should contact their doctor immediately.
• Following VATS, patients need to rest thoroughly to allow their body to heal correctly. They should also avoid strenuous activities until cleared by their doctor.
• Patients may be prescribed medications such as antibiotics or pain relievers in order to help manage any discomfort they may experience during the recovery process.
• In addition, patients may be asked to attend follow-up appointments with their doctor in order to monitor their progress and ensure that the surgery was successful and that there are no issues with healing or recovery.
• During these appointments, the doctor will check on the patient’s progress and make sure that everything is going as expected.
• Overall, following proper aftercare instructions after undergoing VATS can help ensure a successful recovery process and reduce the risk of any complications arising from the procedure.

Video-assisted Thoracoscopic Surgery (VATS) is a minimally invasive surgical method used to detect and manage a variety of thoracic disorders. It is often used to diagnose and treat lung cancer, as well as other conditions such as pleural effusions, pneumothorax, and empyema.

VATS has the potential to reduce pain, shorten recovery time, reduce the risk of infection, and improve patient outcomes when compared to traditional open surgery. While VATS is not suitable for all patients or all conditions, it has become an increasingly popular option for those who are candidates for this type of surgery.