Overview of Video Assisted Thoracic Surgery Treatment India

Video-Assisted Thoracic Surgery is a minimally invasive surgery to diagnose and treat chest related problems. It is commonly performed to remove part of the lung due to cancer. Commonly known as VATS, it is performed with a thoracoscope using special instruments and small incisions to minimize the pain. It is also known as pleuroscopy, thoracoscopic surgery or thoracoscopy.

Human body has 2 lungs - right and left lung. These lungs are connected to the mouth through several tubes. These tubes help lungs to bring oxygen into the body and get rid of carbon dioxide from the body. If part of the lung is removed during the surgery, the remaining lung tissue is enough to provide oxygen and remove carbon dioxide.

During this procedure, a tiny camera is inserted in the chest that transmits images of the inside of the chest onto the video monitor. Surgeons will make 3 small incisions approximately 1-inch of each. It has added benefits over traditional surgery, which includes:

01. Shorter hospital stay

02. Decreased pain

03. Fast recovery

04. Reduced risk of infection

05. Less bleeding

Types of Video Assisted Thoracic Surgery Treatment India

Types of VATS

01. VATS Lobectomy - Lobectomy is the common surgery performed to treat lung cancer. It is traditionally performed during thoracotomy surgery. In thoracotomy procedure, a large incision is made on the side of the chest. The ribs are spread apart to get access to tumor or affected tissue. VATS lobectomy allows surgeons to perform the same operation using a minimally invasive approach.

In this procedure, surgeons will make three 1-inch incisions and one 3 to 4 inch incision to get access to the tumor without spreading ribs. The surgeon will be able to see the inside of the chest with the help of a small video camera which will be inserted through a small incision. The procedure is carried out with other long and small instruments passed through another incision. However, this surgery is best for stage 1 lung cancer only.

02. VATS Sympathectomy - In this procedure, two 2mm incisions are made to pass a tiny video camera. Almost all patients are discharged from hospital the same day.

03. VATS Removal of Mediastinal Masses - The tumors that occur in posterior mediastinum (area in the middle of the chest between the lungs) are benign. These tumors are removed by VATS.

04. VATS Resection of Lung Metastases - Lung metastases are small nodules in the periphery of the lung. VATS provides excellent exposure of the lung to surgeons to perform surgery easily. It reduces postoperative pain, surgical trauma, decreases hospital length of stay and more.

05. Minimally Invasive Esophagectomy - The esophageal tumor is removed by small abdominal incisions and small incisions in the right chest.

VATS Procedure Steps

Before Procedure

Surgeons will perform some medical tests to analyze whether video-assisted thoracoscopic surgery is good for you or not. These tests may include:

01. Chest X-ray to see lungs and heart

02. Chest CT scan to see detailed photos of lungs

03. PET Scan for cancer tissue

04. Pulmonary function tests to see functionality of lungs

05. Blood test to check overall health

06. Electrocardiogram for heart rhythm

Surgeon will give you specific instructions before the surgery. If there is any hair on the surgical site, it will be removed before surgery. These instructions may include:

01. Stop taking blood thinners

02. Quit smoking before and after surgery

03. Daily exercise is important, especially breathing exercise

04. Do not eat or drink anything after midnight (a day before surgery)

During Procedure

You will be given general anesthesia, and antibiotics to prevent infection. A breathing tube will be inserted in the throat to provide oxygen to lungs. It will take 2 to 3 hours to perform this surgery.

Surgeons will make small incisions over the chest wall. Surgeons will insert tiny video cameras through one of these incisions and other specially designed surgical instruments through other incisions. He or she will remove the damaged tissue or part of the lung during the surgery. Once the procedure is completed, all the instruments and camera will be removed. The surgical site will be closed with the sutures and bandage will be applied.

After Procedure

Patient will wake up after a couple of hours of the surgery. Medical staff will closely monitor your overall health conditions post-surgery. There will be a small tube in the nose for oxygen and a tube in the chest to collect fluid from lungs. One may feel soreness and pain as well. Medical staff will help you to walk to prevent blood clots. Hospitalization of a few days is required.

Recovery after VATS

Your surgeon will provide instructions on recovery tips before you go home. Not allowed to drive for a few weeks so make sure you have someone who can drive you home.

You will feel fatigue for several weeks but will recover strength gradually. Walking several times a day is recommended to prevent blood clots. Your surgeon will tell when it is safe to drive. However, you will be prohibited from lifting anything heavy for several weeks.

Most people can resume back their daily work activities within 3 to 4 weeks. Follow all the instructions carefully provided by your doctor about exercise, medicine, diet and wound care.

A follow-up visit is required after 7 to 10 days of surgery. In this visit, surgeons will assess the wound sites and will remove staples or stitches in this visit. If you notice any signs of fever, infection, swelling or pain that is not controlled by a painkiller, call your surgeon immediately.

Diagnosis of Video Assisted Thoracic Surgery Treatment India

Why is VATS required?

Surgeons perform VATS for several reasons and on a variety of conditions. Doctors may perform it to remove a small portion of tissue, and perform a biopsy of the lung, tissue around the lungs, lymph nodes, esophagus or tissue around the heart. It can also be performed to completely remove part or all organs. There are several cardiac procedures that may use VATS. These procedures include pacemaker placement, atrial fibrillation ablation and repair to the mitral valve. Moreover, there are other procedures as well using VATS. These include:

01. Hernia repair

02. Draining fluid around the heart

03. Thymectomy

04. Esophagectomy

05. Treat certain types of esophageal disorders

06. Draining part of the lung

07. Lung surgery to treat lung cancer

08. Draining an abscess

09. Hyperhidrosis (Surgery for excessive sweating)

10. Fix congenital problems of the chest wall

11. Recurrent pleural effusions

12. Treating gastroesophageal disease

Candidate for VATS

If you are recommended thoracic surgery, the VATS approach will be considered as the first option. It is also a good option for those who are not candidates for open surgery due to other health issues. However, it is not a good option for those who had chest surgery in the past. Surgeons will carefully evaluate your overall health before deciding on any surgical approach.

Symptoms and Risk factors

VATS Surgery Complications

The possible complications of video-assisted thoracoscopic surgery are:

01. Lung infection (Pneumonia)

02. Bleeding

03. Nerve damage (permanent or temporary)

04. Damage to nearby organs

05. Side effects of anesthesia

06. Air leak

07. Abnormal heart rhythmus

08. Collapsed lung

09. Empyema (thick pus in chest cavity)

10. Blog clot

11. Wound infection

Benefits of VATS

Before the minimally invasive approach, surgeons used to perform open surgeries to access the chest cavity. In this traditional surgery, a large incision was made in the chest and to reach to damage tissue, the surgeon spread multiple ribs. This is not the case with VATS. In VATS, small incisions are made and a high-tech small camera is inserted in the chest. There is no spreading of ribs in VATS. Due to this, it provides additional advantages for patient, including:

01. Shorter hospital stay

02. Fast recovery

03. Ready to do daily activities in few weeks

04. Less scarring

05. Decreased pain

06. Less risk of infection

07. Better surgical results

08. Reduced immunosuppression after surgery

Top Hospitals for Video Assisted Thoracic Surgery in India

Shaping the future of the healthcare institution and establishing the path to accomplishment.

Manipal Hospital, Pune Pune,India

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Top Doctors for Video Assisted Thoracic Surgery in India

Empower your Health with the Expertise of Leading Medical Professionals.

Dr. Ajay Kaul

Department of Cardio Thoracic and Vascular Surgery

Senior Consultant

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Dr. Bhushan Dinkar Thombare

Department of Oncology & Thoracic surgery

Consultant

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Dr. Arul Furtado

Department of Cardio Thoracic Vascular Sciences

Consultant

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Dr. Navdeep Singh Nanda

Department of Thoracic surgery

Associate Consultant Thoracic Surgeon Surgical Oncology

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Dr. Shaiwal Khandelwal

Department of Thoracic surgery

Senior Consultant

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Video Assisted Thoracic Surgery - Frequently Asked Questions

Video-assisted thoracoscopic surgery is a minimally invasive procedure in which small incisions are made and a small tube is inserted between the ribs. At the end of the tube there is a small camera which helps the surgeon to see the entire chest cavity.

The stitches or staples in the incisions are removed in the first follow-up appointment. The recovery time depends on the surgery performed. However, it may take 3 to 4 weeks to recover fully from VATS surgery.

The traditional thoracic surgery is painful as compared to VATS surgery. The pain is chronic in traditional thoracic surgery and is associated with symptoms of shooting, burning, shocking and aching sensations.

It takes about less than one hour.

Surgeons perform VATS to completely remove part or all of lungs or organs, because of cancer. Moreover, it provides additional benefits over traditional surgery.

Coughing is the main complication in those who underwent surgery for non-small cell lung cancer. It is normal to have these complications and your surgeon will give medications for this.