Video Assisted Thoracic Surgery (VATS)

VATS Lobectomy/Segmentectomy

For some small, localized cancers, surgical removal of the lobe or segment containing your cancer or regional lymph nodes is the best way to achieve a cure. It is also the best method to reduce the risk of cancer from coming back. Alternative treatments include localized radiation called SBRT, or systematic treatment which may include chemotherapy and radiation.

Your operation can be done through a minimally invasive video-assisted approach. After the operation, you will have a tube in your side to drain air and fluid. This is usually removed 2 days after your operation. Most patients will go home after 2 or 3 days.

Our main objective is to do a safe and complete operation. If for any reason those things are not possible through a minimally invasive approach (for example scaring in the chest or anatomy that is different than we expect), we will convert to a standard open surgery while you are asleep.

An important reason for needing a bigger incision is major bleeding. This is an emergency situation, and you may lose a large amount of blood. Transfusion and admission to the ICU is not uncommon when this happens. Some patients also have more minor bleeding after the operation. Rarely, this may require a second operation to manage. Other risks include the need to perform more extensive surgery, for example taking out two lobes or the whole lung. This is a rarely needed.

While in the operation, risks related to anesthesia, abnormal heart rhythms or heart attacks can occur. After the operation, blood clots and strokes are also risks and you will be kept on blood thinners to minimize this risk. Pneumonias are very dangerous after a lung operation. We will be encouraging you to breath deeply and cough, walk and use your incentive spirometer every day.

Some patients, especially those with COPD, can leak some air between the lung and the chest wall while the lung is healing. This is called an “air leak”. If it happens you may be in the hospital extra time. You may also go home with the chest tube and a special device called a Heimlich valve to make sure your lung stays expanded. Rarely, additional chest tubes or a second operation are required to fix large air leaks.

Patients with COPD are also at greater risk of needed oxygen at home. This tends to be temporary, but if will discuss with you in the hospital if needed. Wound infections are rare but can happen. Your nursing team will be looking for signs of infection. 

This is not a complete list, and the concerns for every patient are different based on your medical history. If you have any questions we didn’t review, please let us know.