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What is Video-Assisted Thoracoscopic Surgery?

By D. Jeffress
Updated May 17, 2024
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Video-assisted thoracoscopic surgery is a procedure performed to help diagnose and treat many different conditions affecting the lungs or chest cavity. It is a minimally-invasive surgery that involves making a small incision in the chest and guiding a fiber optic camera tube into the open space around the lungs. The camera relays real-time video to a computer monitor, allowing surgeons to carefully inspect internal tissue. With the aid of the video feed, precision scalpels and other surgical tools can be used to collect biopsies or remove suspicious masses. Innovations in video-assisted thoracoscopic surgery represent major advancements in the safety and accuracy of delicate lung operations.

As a diagnostic tool, video-assisted thoracoscopic surgery can be used to detect signs of damaged or weakened lung tissue. The procedure may reveal pneumonia infections, trauma to the lungs, or slow air and fluid leaks into the chest cavity. In addition, the surgery can be used to check for certain types of lung and lymph node cancer, including mesothelioma, granuloma, and lymphoma. Biopsies are collected and analyzed when tumors are discovered to confirm the diagnosis.

Video-assisted thoracoscopic surgery can also be performed to treat certain conditions. If fluid builds up in the chest cavity or the lining of the heart, a vacuum tube can be inserted and guided via the camera to drain it. Small, well-defined cancerous and benign tumors can be excised with scalpels. In addition, a surgeon can utilize the procedure to suture, staple, or cauterize tears along the lungs.

When a patient is scheduled for video-assisted thoracoscopic surgery, he or she is placed under general anesthesia and given intravenous blood pressure-stabilizing medications. Vital signs are constantly monitored to make sure complications do not arise. An incision about 1 inch (about 2.5 centimeters) wide is made between two ribs, and a camera tube called a thoracoscope is inserted. The surgeon carefully maneuvers the thoracoscope around the chest cavity and lungs to identify abnormalities. When the procedure is purely diagnostic and a biopsy does not need to be performed, the surgery can usually be completed in less than one hour.

If a surgeon does decide to collect tissue or treat a condition, one or more additional small incisions may be made in the chest. Precision surgical equipment is carefully inserted, and the surgeon watches the video feed to make sure the tools reach their destination. Following a successful procedure, tools are removed and the skin incisions are sutured. Patients generally need to stay in the hospital for several days after surgery so doctors can monitor their recovery.

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