Video-Assisted Thoracoscopic Surgery
What is VATS ?
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Why do you need VATS?
VATS involves the use of a thoracoscope and specialized instruments inserted through small incisions to perform procedures in the thoracic cavity. It is indicated for:
- Diagnostic purposes: Biopsy of lung, pleura, or mediastinal masses to diagnose cancer, infections, or interstitial lung disease.
- Therapeutic procedures:
- Lung resection: Lobectomy, wedge resection, or segmentectomy for lung cancer or benign lesions.
- Pleural procedures: Pleurodesis for recurrent pleural effusion or decortication for empyema.
- Mediastinal procedures: Thymectomy for myasthenia gravis or thymomas, mediastinal tumor resection.
- Other: Sympathectomy for hyperhidrosis, repair of diaphragmatic hernias, or treatment of pneumothorax.
- Palliative care: Drainage of malignant pleural effusions or tumor debulking.
Why Do VATS Costs Vary in Philippines?
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VATS Procedure
The VATS procedure is tailored to the patient’s condition and surgical goals:
- Before Procedure Evaluation:
- Diagnosis is confirmed via imaging (CT scan, PET scan, or MRI) to assess the lesion’s size, location, and extent.
- Pulmonary function tests (PFTs) evaluate lung capacity, especially for lung resection.
- Blood tests, ECG, and echocardiograms assess surgical fitness, particularly for patients with comorbidities.
- Biopsy or bronchoscopy may be performed preoperatively to confirm pathology (e.g., cancer, tuberculosis).
- Surgical Technique:
- Performed under general anesthesia, typically lasting 1–3 hours, depending on the procedure.
- The patient is positioned on their side, and single-lung ventilation is achieved using a double-lumen endotracheal tube to collapse the operative lung.
- 2–4 small incisions (0.5–2 cm) are made in the chest, through which a thoracoscope and specialized instruments are inserted.
- The thoracoscope provides a high-definition view of the thoracic cavity, displayed on a monitor, guiding the surgeon’s movements.
- Common VATS procedures include:
- Wedge resection: Removal of a small lung section for biopsy or early-stage cancer.
- Lobectomy: Removal of a lung lobe for cancer or infection.
- Thymectomy: Removal of the thymus for myasthenia gravis or thymomas.
- Pleurodesis: Sealing the pleural space to prevent fluid buildup.
- Chest tubes are placed to drain fluid or air post-surgery, ensuring lung re-expansion.
- Robotic-Assisted VATS:
- Uses robotic systems (e.g., da Vinci) for greater precision, particularly for complex procedures like thymectomy or lobectomy.
- Involves similar incisions but with robotic arms controlled by the surgeon.
- Post-Procedure:
- Patients are monitored in the ICU or high-dependency unit for 1–2 days to manage pain, breathing, and chest tubes.
- Hospital stay lasts 2–5 days, depending on the procedure (e.g., biopsy vs. lobectomy).
- Chest tubes are removed once drainage and lung expansion stabilize.
- Pathology reports guide further treatment (e.g., chemotherapy for cancer, antibiotics for infection).
Recovery After VATS
Recovery depends on the procedure, patient’s health, and underlying condition:
- Hospital Stay:
- Simple VATS procedures (e.g., biopsy, pleurodesis) require 1–3 days, often with minimal ICU time.
- Complex procedures (e.g., lobectomy, thymectomy) involve 3–5 days, with 1–2 days in the ICU.
- Post-Procedure Care:
- Pain is managed with medications (e.g., paracetamol, NSAIDs, or opioids initially).
- Chest tubes are monitored for drainage, typically removed within 1–3 days.
- Breathing exercises (using a spirometer) and physiotherapy prevent lung complications and improve capacity.
- Antibiotics reduce infection risk, particularly for patients with compromised immunity.
- Activity and Diet:
- Light walking is encouraged within days to prevent blood clots and promote lung expansion.
- Strenuous activities, heavy lifting, or driving are avoided for 2–4 weeks (simple procedures) or 4–6 weeks (complex procedures).
- A balanced diet supports healing; patients with lung cancer or infections may need high-protein intake.
- Follow-Up:
- Follow-up visits at 1, 3, and 6 months include chest X-rays, CT scans, or PFTs to monitor recovery and detect complications (e.g., cancer recurrence).
- Long-term follow-up is critical for cancer patients or those with chronic conditions like myasthenia gravis.
Most patients resume normal activities within 2–6 weeks, significantly faster than open surgery (6–12 weeks). For lung cancer, VATS lobectomy offers 5-year survival rates of 60–80% for early-stage disease, comparable to open surgery but with less morbidity.
Risks and Complications
VATS is less invasive than open surgery but carries risks:
- Surgical Risks:
- Bleeding or infection at incision or chest tube sites.
- Conversion to open surgery (thoracotomy) in 5–10% of cases due to technical difficulties or complications.
- Lung-Related Complications:
- Prolonged air leaks, delaying chest tube removal.
- Pneumonia or atelectasis (lung collapse), preventable with breathing exercises.
- General Risks:
- Adverse reactions to anesthesia.
- Blood clots (deep vein thrombosis or pulmonary embolism), requiring anticoagulants.
- Procedure-Specific Risks:
- Incomplete resection of tumors, requiring further surgery or therapy.
- Nerve injury (e.g., phrenic or recurrent laryngeal nerve) during thymectomy, causing breathing or voice issues.
Prompt reporting of symptoms like fever, chest pain, or shortness of breath ensures timely management.
Frequently Asked Questions (FAQs)
What conditions can VATS treat?
VATS is used for lung cancer, thymomas, myasthenia gravis, pleural effusions, pneumothorax, hyperhidrosis, and diagnostic biopsies.
Is VATS better than open surgery?
VATS offers faster recovery, less pain, and smaller scars but is suitable only for select cases (e.g., early-stage cancer, non-invasive tumors).
How painful is VATS recovery?
Pain is milder than open surgery, manageable with oral medications, and typically subsides within 1–2 weeks.
How soon can I resume normal activities?
Simple VATS patients resume activities in 2–4 weeks; complex procedures take 4–6 weeks.
Is VATS covered by insurance in India?
Most insurance plans cover VATS for diagnostic or therapeutic indications. Confirm with your provider.
What are the signs of complications post-VATS?
Fever, chest pain, shortness of breath, or excessive drainage require immediate medical attention.
Can VATS be used for children?
Yes, VATS is performed in pediatric centers like Apollo Children’s Hospital for conditions like congenital lung lesions or mediastinal tumors.
What lifestyle changes are needed post-VATS?
Quit smoking, avoid respiratory irritants, maintain a healthy diet, and follow rehabilitation for lung procedures or oncology care for cancer.
Conclusion
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Looking for Best Hospitals for VATS
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.