Video-Assisted Thoracic Surgery (VATS) Lobectomy
Swedish Thoracic Surgery / First Hill
Surgeons at SCI Thoracic Surgery introduced and pioneered the use of VATS (Video Assisted Thoracic Surgery) in the Pacific Northwest in 1997. Since that time, we have performed over 200 VATS lobectomies using this minimally invasive approach. Because of our significant experience with VATS, we are now able to offer this approach to a growing number of patients with more complex surgical demands.
What Is a VATS Lobectomy?
VATS is a surgical technique that accesses the lung through small incisions -- versus the larger incisions required in conventional open surgery. In a VATS procedure, a tiny video camera is inserted through one of these smaller incisions, allowing surgeons to view the lung on a high-definition monitor and pinpoint the area that contains the tumor. Then, using special surgical staplers and clips, surgeons can go in and remove the diseased portion of the lung.
What Are the Potential Advantage of VATS Lobectomy?
For appropriate patients, the VATS approach potentially offers the following benefits:
- a shorter stay in hospital
- less pain and consequently less need for pain medication
- faster recovery time after leaving the hospital
- similar survival compared to conventional lung surgery
What Are Potential Complications of VATS Lobectomy?
The potential complications of VATS lobectomy are basically the same as those of conventional open lobectomy. Air leak (leakage of air from the lung that was operated on) is the most common complication. This leakage usually stops on its own within the first three to four days after surgery. As seen with other video camera approaches to surgery, conversion (going from VATS to open surgery) during a VATS operation is always possible. The most frequent reasons for converting to conventional open surgery include the presence of scar tissue in the chest, which makes VATS dissection difficult and potentially dangerous, and the occurrence of bleeding from one of the major blood vessels.
What Are the Results of VATS Surgery?
At SCI Thoracic Surgery, we have performed over 200 VATS lobectomies for lung cancer and other tumors of the lung without any intra-operative or hospital deaths. We have converted to the conventional open surgery in less than 3 percent of our cases. We have recently compared the results of patients undergoing VATS lobectomy at Swedish Cancer Institute to those patients who had similar tumors that were operated by the conventional open approach and found that the treatment ((treatment what? Treatment outcomes – i.e., similar survival time as you mention on previous page)) of their lung cancer was equivalent. (In press)
Which Patients May Be Candidates for VATS Lobectomy?
Generally, patients with early stage lung cancers or non-cancerous conditions of the lung are offered VATS lobectomy. Our patients undergo standard pre-operative investigations for their lung tumor including CT scan, PET scan and pulmonary function tests. Patients who, after pre-operative testing, have tumors that are less than 5 cm and who have no evidence of spread of the tumor beyond the lung usually are considered for VATS lobectomy.
Patients who have been treated with chemotherapy and/or radiation therapy, who have tumors larger than 5 cm, or whose tumors have grown beyond the lung are usually not candidates for VATS lobectomy.
Patients who are older than 80 years of age, with significant emphysema and previous lung surgery may still be candidates for VATS lobectomy.