What is video-assisted thoracoscopic surgery?

VATS is a way to do surgery inside the chest. With open surgery, the doctor makes one large cut in your chest. But with VATS, the doctor makes several small cuts. VATS also differs from open surgery because the doctor does not have to cut through the ribs or breastbone (sternum). The doctor can use VATS to find and treat many problems in the chest.

To start, the doctor will make several small cuts between your ribs. These cuts are called incisions. The doctor will put a thin, lighted tube with a camera on it into your chest. This tube is called a thoracoscope, or scope. It lets the doctor see inside your chest. Then the doctor will use tiny surgical tools to do the surgery. The doctor will close the incisions with stitches or staples.

How long you stay in the hospital and how long your recovery takes will depend on why you are having the surgery.

The scars from the incisions will fade with time. The area around the incisions may ache or feel numb in the weeks after surgery.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
• If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
• Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
• If you have an advance care plan, let your doctor know. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of surgery?

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be cancelled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
• The surgery will probably take about 1 to 3 hours.
• You may have one or more tubes coming out of your chest. They drain fluid and air.

Going home

• Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
• You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

When should you call your doctor?

• You have questions or concerns.
• You don't understand how to prepare for your surgery.
• You become ill before the surgery (such as fever, flu, or a cold).
• You need to reschedule or have changed your mind about having the surgery.