Overview

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgical technique used to diagnose and treat problems in your chest.

During a VATS procedure, a tiny camera (thoracoscope) and surgical instruments are inserted into your chest through one or more small incisions in your chest wall. The thoracoscope transmits images of the inside of your chest onto a video monitor, guiding the surgeon in performing the procedure.

Why it's done

Surgeons use the video-assisted thoracoscopic surgery technique to perform a variety of procedures, such as:

  • Biopsy to diagnose lung cancer, mesothelioma and other chest cancers
  • Lung surgery, such as surgery to treat lung cancer and lung volume reduction surgery
  • Procedures to remove excess fluid or air from the area around the lungs
  • Surgery to relieve excessive sweating (hyperhidrosis)
  • Surgery to treat certain types of esophageal disorders
  • Surgery to remove part or all of the esophagus (esophagectomy)
  • Hiatal hernia repair
  • Thymus gland removal surgery (thymectomy)
  • Certain procedures involving the heart, ribs, spine and diaphragm

Risks

Possible complications of video-assisted thoracoscopic surgery include:

  • Pneumonia, a lung infection
  • Bleeding
  • Temporary or permanent nerve damage
  • Damage to organs near the procedure site
  • Anesthesia-related effects

VATS can be a good option for people who are not good candidates for open surgery due to health concerns. However, VATS may not be appropriate for people who have had chest surgery previously. Talk with your doctor about these and other risks of VATS.

How you prepare

You may need to have some tests to determine whether video-assisted thoracoscopic surgery is a good option for you. These may include imaging tests, laboratory tests, pulmonary function tests and cardiac evaluation.

If you're scheduled for surgery, your doctor will give you specific instructions to help you prepare.

What you can expect

Usually people undergoing video-assisted thoracoscopic surgery are given a general anesthetic, which means they're asleep during surgery. You'll have a breathing tube put down your throat into your trachea to provide oxygen to your lungs. Then a surgeon makes small incisions in your chest and inserts specially designed surgical instruments to perform the procedure.

During VATS, you may be in surgery two to three hours and may stay in the hospital for a few days, though that can vary, depending on the extent of the procedure and your situation.

Results

When compared with a traditional open operation (thoracotomy), video-assisted thoracoscopic surgery typically results in less pain, fewer complications and shortened recovery time.

If the purpose of VATS is to biopsy tissue, you may need additional surgery, depending on the results of the biopsy.

Video-assisted thoracoscopic surgery (VATS) care at Mayo Clinic

Jan. 28, 2020
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  2. Bendixen M, et al. Postoperative pain and quality of life after lobectomy via video-assisted thoracoscopic surgery or anterolateral thoracotomy for early stage lung cancer: A randomized controlled trial. Lancet Oncology. 2016; doi:10.1016/S1470-2045(16)00173-X.
  3. AskMayoExpert. Video-assisted thoracoscopic surgery (VATS) lobectomy. Mayo Clinic; 2019.
  4. Raft J, et al. Anesthesia for thoracic ambulatory surgery. Current Opinion in Anesthesiology. 2019; doi:10.1097/ACO.0000000000000795.
  5. Rowse PG, et al. Minimally invasive thymectomy: The Mayo Clinic experience. Annals of Cardiothoracic Surgery. 2015; doi:10.3978/j.issn.2225-319X.2015.07.03.
  6. Bencini L, et al. Esophageal surgery in minimally invasive era. World Journal of Gastrointestinal Surgery. 2016; doi:10.4240/wjgs.v8.i1.52.
  7. Demmy T, et al. Overview of minimally invasive thoracic surgery. https://www.uptodate.com/contents/search. Accessed Oct. 11, 2019.
  8. Oshikiri T, et al. Current status of minimally invasive esophagectomy for esophageal cancer: Is it truly less invasive? Annals of Gastroenterological Surgery. 2019; doi:10.1002/ags3.12224.
  9. Brown A. Allscripts EPSi. Mayo Clinic. July 30, 2019.
  10. Litin SC (expert opinion). Mayo Clinic. Dec. 6, 2019.

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Video-assisted thoracoscopic surgery (VATS)