Video-assisted thoracic surgery (VATS) for the diagnosis and treatment of lung cancer

Video-assisted thoracic surgery (VATS) is a novel technique used in thoracic surgery that has transformed how pulmonary and cardiac conditions, such as lung cancer, are assessed and managed.

Here, Dr Igor Saftic, renowned consultant thoracic surgeon in Bristol, provides an expert into VATS. He explains how VATS is used for lung cancer, what are the advantages and potential risks, and how VATS differs to robotic-assisted thoracic surgery, among other important points.

How is video-assisted thoracic surgery (VATS) used to treat lung cancer?

Video-assisted thoracic surgery (VATS) is a minimally invasive surgical technique used for the diagnosis and treatment of various chest conditions. This includes lung cancer.

During a VATS procedure, a camera and specialised surgical instruments are inserted into the chest through a very small incision, as opposed to traditional open surgery which employs a large incision.

When it comes to lung cancer treatment, the main objective of VATS is to remove the cancerous lung tissue while leaving as much healthy lung tissue intact. The surgical technique can be used in different lung cancer treatment procedures, including:

1. A biopsy, where a small sample of lung tissue is removed to be examined under a microscope. This is done to determine if the suspected tissue is cancerous or benign.
2. A wedge resection, where a small part of the lung that contains the cancer is removed.
3. A segmentectomy, where a portion of one lobe of one of the lungs is removed alongside with a few blood vessels and airways. This procedure is generally recommended for small lesions.
4. A lobectomy, where an entire lobe of one of the lungs that contains the cancer is removed.
5. A pneumonectomy, where an entire lung that contains the cancer is removed.

VATS offers various advantages over traditional open surgery. These include smaller scars, decreased pain after surgery, shorter hospital stays, and quicker recovery time.

However, it is important to know that not all patients who have lung cancer are suitable candidates for VATS. This is because the surgical technique requires good functioning of the lungs, and for the tumour to be a certain size and to be found in a certain location.

Your consultant thoracic surgeon will determine and advise you on the best course of treatment for your individual case.

What are the potential risks and complications associated with video-assisted thoracic surgery (VATS)?

Like with any surgical procedure, there are potential risks and complications associated with the use of VATS. However, when performed by qualified surgeons in suitable patients, VATS is typically considered a safe and effective surgical technique.

The possible risks and complications that can occur with VATS include:

1. Bleeding, which may occur during or after the operation. This complication may need to be managed with blood transfusion or additional surgery.
2. Infection, which may develop at the site of incision or in the cavity of the chest.
3. Pain at the site of incision. Although common following surgery, this pain usually improves after a couple of days.
4. Prolonged air leak, where air seeps from the lungs into the cavity of the chest. This complication may require the chest drain to remain longer in place.
5. Nerve damage in the chest, which can lead to numbness or weakness in the arms or the hands. However, this is rare.
6. Complications with anaesthesia, for VATS is performed under general anaesthesia. This poses it own set of risks, including allergic reactions and breathing problems.
7. Conversion to open surgery, if there are unexpected findings or complications during the operation.

Before undergoing a VATS procedure, it is important to discuss any potential risks and complications with your consultant thoracic surgeon, who will help you understand the benefits and the risks of the procedure and determine if VATS is the best treatment for you.

How does video-assisted thoracic surgery (VATS) compare to robotic-assisted thoracic surgery (RATS) in terms of recovery time and outcomes?

VATS and RATS are two effective minimally invasive surgical techniques used for the treatment of lung cancer and other chest conditions. While both techniques offer several advantages, there are some differences between them.

Recovery time:

VATS and RATS both generally result in shorter hospital stays and quicker recovery times when compared to traditional open surgery. Studies have shown, however, that RATS may be associated with decreased pain and an earlier return to normal activities in comparison to VATS.

Outcomes:

Several studies have analysed the differences in outcomes of both techniques. While results are mixed, overall, the studies suggested that RATS may have some advantages over VATS.

Despite this, it is important to know that these studies are inconclusive and other factors may need to be considered when it comes to deciding between VATS and RATS. These include the size and the location of the tumour, the expertise and the experience of the surgeon, and the robotic equipment available.

The best option for you depends on several factors and should be determined in consultation with your consultant thoracic surgeon.

Dr Igor Saftic is a renowned consultant thoracic surgeon with over 20 years’ experience who specialises in minimally invasive surgery for lung cancer and other conditions of the chest, such as pneumothorax and plural effusion.

If you require video-assisted thoracic surgery (VATS) and would like to discuss your options with an expert, do not hesitate to book an appointment with Dr Saftic via his Top Doctors profile today.