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VATS Surgery for Lung Cancer

VATS Approach

The VATS approach allows the surgeon to access the problem area by using advanced instrumentation such as a long, thin tube (endoscope) with an attached camera and other small endoscopic instruments and endostaplers. These instruments can be inserted into the chest through small 2-4 cm incisions made between the ribs (see image).The scope allows the surgeon to view, under high magnification, the cancerous lung tissue and manipulate the instruments to effectively remove the tissue from the body.

While surgeons may choose either the traditional surgery or the minimally invasive approach for most lung cancer procedures, the latter offers a number of advantages, particularly in early stage lung cancer treatment. First, VATS does not require any rib spreading, which results in a less invasive procedure. Other key benefits to consider relate to pain following surgery, size of the incision, anesthesia and length of stay in the hospital.

Benefits of VATS Over Traditional Open Approach

  • Less pain after the operation,
  • Better immune system response,*
  • Better chance of breathing normally and
  • Better quality of life.

VATS may not be appropriate for some cases that require the surgeon to have greater access to the problem area.Other variables that may limit the use of VATS are location of the tumor, size of the tumor, prior chemotherapy or radiation therapy and prior chest surgery.

*VATS is associated with reduced cytokine production.Cytokines regulate the immune system and certain cytokines associated with the body’s inflammatory response have been linked to a better lung cancer prognosis when they are at lower levels.

Thoracotomy (Traditional) Versus VATS (Minimally Invasive

TraditionalMinimally Invasive
Pain Incisions and your chest area may be painful for several weeks to months after surgery and sometimes longerWhile pain in the hospital will still occur, it is usually less than that experienced with a thoracotomy*
Incision Size One large incision 10-15 cmOne main incision 4-6 cm (usually 4.5 cm); multiple additional incisions, typically 2-4 cm
Anesthesia GeneralGeneral
Eligibility Stages I-IIIAStages I-IIIA
Length of Hospital Stay Up to 7 days3-4 days
Incision Placement

*Occasionally, patients can suffer longer term pain; however, current data indicates that two-thirds of patients do not require major pain management beyond 3 weeks.