Minimally invasive surgery involves minor surgical cuts, which may lead to less pain and a shorter hospital stay. It’s used in many types of surgery, including thoracic procedures. Several studies have proven that minimally invasive techniques are as effective as traditional surgery in treating lung, pleural, and mediastinal pathologies.
Thoracoscopy
During a thoracoscopy, a physician uses a long, thin tube called a thoracoscope that is equipped with a lighted video camera. The thoracoscope sends images of the inside of your chest to a video monitor in the operating room. It allows the surgeon to see areas of your lung that aren’t visible on X-rays or CT scans. The thoracoscope can also take tissue samples (biopsies) from the pleura or tissue surrounding your lungs. It helps doctors diagnose thoracic cancers like mesothelioma and other chest diseases. It can also help drain fluid buildup in the pleura, called a pleural effusion. Armen Parajian performs thoracoscopy under general anesthesia, but some people have this procedure done with local anesthesia and “conscious sedation.” Newer thoracoscopes have a smaller diameter, allowing surgeons to insert the instrument through fewer incisions. It is called uniportal video-assisted thoracic surgery.
Thoracotomy
Surgical techniques continue to evolve from open to minimally invasive techniques. This evolution is an integral part of the training of contemporary thoracic surgeons. It is recommended that residents be exposed to a variety of procedures, including VATS and thoracotomy. In a thoracotomy, your doctor makes an incision on your chest through which they can operate. They will open your rib cage and may remove or break a bone to reach your lungs. It allows them to perform lung cancer surgery or treat other pulmonary conditions. Thoracotomy can also be used for other procedures that cannot be done with thoracoscopy, such as biopsies and removing large pieces of your lungs or chest wall. It can also help treat pleural effusion and water around your lungs. It can be due to pneumonia or cancer. It can cause pain and breathing problems, which your doctor will treat with medication.
Video-Assisted Hybrid Thoracic Surgery (VAHTS)
Many diseases/problems in the chest cavity previously performed via large open thoracotomies are now successfully diagnosed and treated with minimally invasive techniques. The list is growing as surgeons become more proficient and technological advances occur. Video-assisted thoracoscopic surgery (VATS) is currently the surgical procedure of choice for lung resection procedures. Its adoption has reached a tipping point in dedicated general thoracic centers and is rapidly approaching or surpassing open thoracotomy in lung resections.
In VATS, a small tube with a camera at the end of it is inserted through one or more (four) minor cuts in your chest. Your surgeon then uses the images on a video screen to guide surgical instruments that remove diseased tissue or organs. Some surgeons prefer to use only a single utility incision for all VATS procedures (uniportal). It reduces operative time and the number of needlestick injuries but may require enlargement of the incision to accommodate a thoracoscope or to extract specimens.
Video-Assisted Thoracic Surgery (VATS)
Using a tiny incision, a camera, and surgical instruments are inserted into the chest during VATS, a minimally invasive procedure. It is used to diagnose and treat lung cancer and other tumors of the thoracic cavity or to remove air or fluid trapped around the lungs (pleural effusion). It can also relieve excess sweating (known as hyperhidrosis). The benefits of VATS include decreased hospital stay, lower risk of complications, and improved recovery time. It is most commonly performed under general anesthesia, although local anesthesia may sometimes be used.
The most advanced form of VATS is known as uniportal video-assisted thoracic surgery or Uni-VATS. This technique combines the benefits of VATS with the reduced trauma of single-port laparoscopy. Patients who undergo Uni-VATS rather than multiportal VATS have shorter hospital stays and fewer postoperative complications. It is likely due to the reduction of perioperative trauma by limiting access to a single intercostal space.
