VATS (Video Assisted Thoracic Surgery)
VATS is a minimally invasive method for performing surgery within the chest. During VATS, your surgeon can view and operate inside the chest using a small camera and long instruments through 2 or 3 small incisions. Using this method, the surgeon may:
- Remove a portion of the lung
- Obtain a biopsy of a tumor
- Drain fluid from around the lung
- Prevent repeated episodes of pneumothorax (collapsed lung)
As compared with traditional chest surgery that uses a long incision, patients who go through VATS often have:
- A faster recovery
- A shorter hospital stay
- Less pain
You will be positioned comfortably on your side. A very small incision is made, usually between the 7th and 8th ribs. A tiny camera on a tube (thoracoscope) is then inserted through the opening. One or two other small incisions are made, and the surgeon will perform the surgery.
At the end of surgery, all but one of the small incisions will be closed. A chest tube is placed in this incision and connected to a container. The tube will drain air and fluid from the chest.
Once in the recovery area, a chest X-ray is taken. Pain medication will be given to keep you comfortable. Oxygen will be given through small tubes that are placed just inside your nose. An IV will remain for needed fluids and medicines. From the recovery room, you will go to the post-operative unit located on 11 West, Feinberg Pavilion.
Your nurse will have you begin coughing and deep breathing exercises right away. This includes using a handheld device called an incentive spirometer. This device allows you to see how deeply they are breathing. Deep breathing is important to:
- Keep your lungs clear of fluid and mucus
- Guard against pneumonia
- Improve how well your lungs work
You should do these exercises 10 times every hour while awake.
Most patients will experience pain that increases when they take deep breaths, cough or move. Medication is available to control the pain. This medication will either be in the form of a pain pump (PCA) which you will control with a button or pain pills which are available from your nurse. Be sure to tell the nurses how the medicine is working.
Rate the pain on a scale of 0 to 10, with 0 meaning no pain, and 10 the worst pain you can imagine. Although the pain medication can’t take away all the pain the goal is to keep it as low on the scale as possible, at a level you can tolerate. Good pain control along with deep breathing and walking will help speed your recovery.
You will begin with a clear liquid diet and progress to their regular diet. If there is any stomach upset, you should tell the nurse. Most patients are out of bed with help on the day of surgery and walking in the hallways the next day. It is important to walk in the hall 4 to 5 times each day.
The IV and chest tube are removed before you go home. Most patients are ready to go home 1 to 3 days after surgery. The nurse will review your home care guidelines with you and will answer any questions. A prescription for pain medicine will be given to you.
Most patients find that they are back to their usual routine within 2 weeks after surgery. Talk with your doctor before returning to work or driving. When you return to work will depend on the nature of your work and its demands. Most patients may resume driving when they are no longer taking pain medicine and can react in an emergency. This is often 2 weeks after your surgery and your follow-up office visit.
Some pain is expected after surgery, but it should lessen each day. Take pain medication with food to prevent nausea. If your pain medicine has acetaminophen or Tylenol® in it, do not take more than 4,000 mg of acetaminophen or Tylenol® in a 24-hour period. Do not take any other medicines containing acetaminophen or Tylenol®. Be sure to contact your doctor for any severe pain not controlled by your pain medication.
If an appointment has not been made for you, call your doctor’s office to schedule a follow-up visit within 2 weeks after your surgery.
When to Call the Doctor
Please call your doctor if you have:
- Temperature of 100.5° F or greater
- Increased swelling, redness, or tenderness at incision site
- Drainage from your incision
- Shortness of breath
- Severe pain not controlled by pain medicine
- Any questions or concerns