Video-assisted Thoracoscopic Surgery

What you should know

• Video-assisted thoracoscopic (thor-ah-KOS-kah-pik) surgery (VATS) is surgery done to look inside your chest using a video scope. VATS is usually done to diagnose or treat conditions of the lungs and pleura (thin lining covering the lungs). These conditions include infections, cancer, and too much air or fluid in the chest cavity. VATS may also be done to give medicines directly to the lungs or do a biopsy (take tissue samples). Your caregiver may also remove small lung nodules (lumps) or a portion of the lung using this surgery. VATS may also diagnose conditions of the spine or esophagus.
  
  
• During this surgery, small incisions (cuts) are made on your chest. The video scope and other special tools are inserted through these small incisions. A video scope is a long bendable tube with a tiny fiber optic camera connected on the end. This gives caregivers a clear view inside your chest while watching the images on a monitor. Having VATS as early as possible may diagnose and treat your condition and prevent further complications.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

• There are always risks with surgery. You may bleed more than expected or get an infection. You may have an allergic reaction to the anesthesia medicine. Your caregivers will watch you closely for these problems. The instruments or tools used during the surgery may break the ribs or injure the nerves. This can add more pain after the surgery.
  
  
• You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.
  
  
• If you do not have the VATS, the symptoms you have may get worse. There would also be a delay in the diagnosis and treatment of your condition. Call or ask your caregiver if you are worried, or have questions regarding your surgery, medicine or care.

Getting Ready

The week before your surgery:

• Ask a family member or friend to drive you home after your surgery. Do not drive yourself home.
  
  
• Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
  
  
• If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your surgery. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before surgery. You may need to check your blood sugar more often before and after having surgery.
  
  
• If you are a female, tell your caregiver if you know or think that you are pregnant.
  
  
• Tell your caregiver if you have had previous surgery done in your chest. Your caregiver will need to know if there may be scar tissue in your chest.
  
  
• You may need to have blood tests, electrocardiogram (ECG), chest x-ray, and other tests. You may be asked to have a pulmonary function test and blood gas exam. Ask your caregiver for more information about tests you may need. Write down the date, time, and location of each test.

The night before your surgery:

• Remove any nail polish.
  
  
• You may be given medicine to help you sleep.
  
  
• Ask caregivers about directions for eating and drinking.

The day of your surgery:

• Write down the correct date, time, and location of your surgery.
  
  
• What to bring: You may want to bring items such as a toothbrush and bathrobe.
  
  
• Ask your caregiver before taking any medicine on the day of your surgery. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.
  
  
• If you wear contact lenses, do not wear them on the day of your procedure or surgery. Glasses may be worn.
  
  
• Do not wear tight-fitting clothes on the day of your procedure or surgery.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your procedure or surgery. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.
  
  
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

Treatment

What will happen:

• You will be asked to change into a hospital gown. You will be taken on a stretcher to the operating room. Medicine called general anesthesia will be given to you to make you sleep and control the pain during surgery. An endotracheal tube (ET) will be put inside your mouth and down to the trachea (windpipe) to help you breathe. The ET tube will be connected to a ventilator (breathing machine). You will be placed lying on your side, with the affected side up and arm raised above your head. A caregiver will clean your chest area and clean sheets will be put over you to keep the area clean.
  
  
• During your surgery, 2 to 3 small incisions (cuts) will be made between your ribs. A video scope and other special instruments will be inserted into these incisions. The lung will be deflated (air removed) to have a better view of other organs inside the chest. A biopsy may be done on a lesion or the lesion may be completely removed. Your caregiver may also remove a portion of the lung if needed. A tube will be placed through an incision to put medicines directly onto the lungs or to drain fluids. This tube will help your lungs fill back up with air after the surgery. The remaining incisions will be closed with stitches (threads).

After surgery:

You are taken to a room where your heart and breathing will be monitored. Do not get out of bed until your caregiver says it is okay. A bandage may cover wounds to help prevent infection. You may be able to go home after some time passes. An adult will need to drive you home and should stay with you for 24 hours. If you cannot go home, you will be taken to a hospital room.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot make it to your appointment on time.
  
  
• You have a fever.
  
  
• You have a skin infection or an infected wound near the area where the surgery will be done.
  
  
• You have questions or concerns about your surgery.

Seek Care Immediately if

• The problems for which you are having surgery get worse.
  
  
• You have difficulty breathing all of a sudden.