VATS - changing the landscape of thoracic surgery

Hardly anyone gets an open surgery done for appendix or gall bladder removal these days—everyone gets a laparoscopic surgery done for it. Similarly, Video-Assisted Thoracic Surgery (VATS) is revolutionizing the way thoracic (chest) procedures are performed. Unlike traditional open surgeries (thoracotomy), VATS employs small incisions and a tiny camera to navigate and visualize the chest cavity, offering numerous benefits for both patients and surgeons.

One of the primary advantages of VATS is its minimally invasive nature. Smaller incisions mean reduced pain, quicker recovery times, and diminished scarring for patients. Additionally, VATS often results in fewer complications and a shorter hospital stay compared to open surgery. The precision provided by the video-assisted approach allows surgeons to target specific areas with greater accuracy, enhancing the overall efficacy of procedures such as lobectomies, mediastinal tumor resections, and pleural surgeries like decortication.

Thoracotomy is a very painful procedure as the chest wall muscles need to be cut and the ribs retracted/removed for carrying out the surgery. Patients take a long time to recuperate, and their breathing capacity also decreases. VATS patients benefit from a faster return to normal activities, promoting a higher quality of life.

Video-Assisted Thoracic Surgery needs to be performed by a trained surgeon performing high volumes of lung surgery as it is technically challenging and involves vital structures around the heart.

Some of the common surgeries performed by Dr. Karthik using VATS include:

1. Lobectomy/Segemental resection:
   
   • In cases of lung cancer, VATS can be used to remove a lobe of the lung or a segment of it while preserving the remaining healthy tissue.
2. Mediastinal Tumor Resection:
   
   • VATS can be used for the removal of tumors located in the mediastinum, the space between the lungs. (Thymomas, schwannomas, cysts, etc.)
3. Esophageal Cancer:
   
   • In the treatment of esophageal cancer, the esophagus needs to be removed.
4. Pleural and lung biopsy:
   
   • VATS facilitates the sampling of tissue from the pleura (lining of the chest cavity) or from lung tumors for diagnostic purposes.
5. Pleurodesis:
   
   • This procedure is performed to treat recurrent pleural effusions by inducing adhesion between the layers of the pleura, preventing fluid accumulation.
6. Sympathectomy:
   
   • For conditions like hyperhidrosis (excessive sweating), VATS sympathectomy involves interrupting the sympathetic nerve signals responsible for sweat gland stimulation.
7. Decortication:
   
   • This procedure involves the removal of fibrous tissue or outer layer from the surface of the lungs, often performed in cases of empyema—done for tuberculosis and chronic chest infections, which are very common in India.
     

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