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VATS Procedure

VATS Surgery

Introduction

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgical method that has made significant progress in the diagnosis and management of numerous pulmonary and cardiac disorders during the last two decades.

A thoracotomy was the conventional method to a thoracic pathology prior to this procedure. In the past, the technique was often used to assess and treat pleural effusions in individuals with pulmonary TB. The invention of fiber-optic light was a technological breakthrough that resulted in the progress of all types of minimal access surgery.

 

The frequency of VATS operations performed has increased over the years as technical improvements have made these treatments safer for the elderly and debilitated. For example, a majority of specialists recommends VATS for the treatment of lobectomies, which are generally performed under general anesthesia with One-Lung Ventilation.

 

Clinical Significance

Because of its safety profile, VATS has gradually replaced open thoracotomies in most thoracic surgical facilities around the world. VATS has the following advantages over traditional thoracotomy:

 

Indications

VATS is used by healthcare professionals to treat a wide range of thoracic diseases. Conditions of the lungs and heart are among them. If you have cancer, you may require it to remove a tiny amount of tissue. VATS may be used to biopsy a portion of the lung, lymph nodes, tissue surrounding the lung, tissue surrounding the heart, or the esophagus.

A.  Diagnostic

 

B.   Therapeutic

 

·      Pleuroscopy

·      Mediastinal lymph  node biopsy

 

·      Tissue/ lymph  node biopsy for lung cancer

·      Pleural /Chest wall biopsy

 

·      Cancer staging

 

·      Pulmonary resection (most commonly for lung cancer)

·      Pulmonary bleb/bullae resection

·      Pleural drainage (pneumothorax, hemothorax, empyema)

·      Pericardial effusion drainage

·      Mechanical/chemical pleurodesis

·      Excision/biopsy of mediastinal masses and nodules

·      Excision of esophageal diverticulum/esophagectomy

·      Thoracic duct ligation

·      Sympathectomy

·      Chest wall tumor resection

·      Thoracoscopic laminectomy

·      Spinal abscess drainage

 

The indications can summarized into Diagnostic or Therapeutic:

 

 

 

 

Technique

 

 

 

 

Contraindications

 

Equipment

Pre-operative Evaluation

 

 

 

 

Post-Operative Care

Pain control, respiratory care, and chest tube management are the three pillars of VATS post-operative care. Restrictive fluid treatment is another important technique for enhancing post-surgery results. You'll have to spend a few days in the hospital.

 

After you leave the hospital:

 

Complications

 

 

 

 

Conclusion

Video-assisted thoracoscopic surgery (VATS) is a surgical method that involves inserting a small tube called a thoracoscopic via a small incision between the ribs. A small camera is located at the tube's end. This allows the surgeon to see the whole chest cavity without opening the chest or spreading the ribs. The care and treatment you will receive will be specific to your needs.

 

 

References

https://www.ncbi.nlm.nih.gov/books/NBK532952/

https://pubmed.ncbi.nlm.nih.gov/20082195/

https://pubmed.ncbi.nlm.nih.gov/9322329/

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/video-assisted-thorascopic-surgery

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