You are doing preoperative teaching for a patient scheduled for a video assisted thoracoscopic ecco

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Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 2

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

  • Anesthesia reaction, such as an allergic reaction and problems with breathing

  • Bleeding, which can lead to shock

  • Blood clot, in particular a deep vein thrombosis 

  • Infection 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 3

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 4

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 5

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 6

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 7

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 8

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

  • Anesthesia reaction, such as an allergic reaction and problems with breathing

  • Bleeding, which can lead to shock

  • Blood clot, in particular a deep vein thrombosis 

  • Infection 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 9

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 10

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 11

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 12

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

  • Anesthesia reaction, such as an allergic reaction and problems with breathing

  • Bleeding, which can lead to shock

  • Blood clot, in particular a deep vein thrombosis 

  • Infection 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 13

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

  • Anesthesia reaction, such as an allergic reaction and problems with breathing

  • Bleeding, which can lead to shock

  • Blood clot, in particular a deep vein thrombosis 

  • Infection 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 14

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 15

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

  • Anesthesia reaction, such as an allergic reaction and problems with breathing

  • Bleeding, which can lead to shock

  • Blood clot, in particular a deep vein thrombosis 

  • Infection 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 16

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

  • Anesthesia reaction, such as an allergic reaction and problems with breathing

  • Bleeding, which can lead to shock

  • Blood clot, in particular a deep vein thrombosis 

  • Infection 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 17

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 18

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 19

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 20

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

  • Anesthesia reaction, such as an allergic reaction and problems with breathing

  • Bleeding, which can lead to shock

  • Blood clot, in particular a deep vein thrombosis 

  • Infection 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 21

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 22

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

  • Anesthesia reaction, such as an allergic reaction and problems with breathing

  • Bleeding, which can lead to shock

  • Blood clot, in particular a deep vein thrombosis 

  • Infection 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 23

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

  • Anesthesia reaction, such as an allergic reaction and problems with breathing

  • Bleeding, which can lead to shock

  • Blood clot, in particular a deep vein thrombosis 

  • Infection 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 24

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 25

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

Was this helpful?

VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

  • Anesthesia reaction, such as an allergic reaction and problems with breathing

  • Bleeding, which can lead to shock

  • Blood clot, in particular a deep vein thrombosis 

  • Infection 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

Was this helpful?

Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020


Page 26

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

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VATS is video-assisted thoracoscopic surgery. It is a type of minimally invasive thoracic surgery. Some medical centers use the term video-assisted thoracic surgery. Doctors use video-assisted thoracoscopy to diagnose and treat lung cancer, pleural effusion, and other chest and lung problems. The VATS procedure involves making at least two small chest incisions. Your doctor inserts a thoracoscope with a tiny camera to view the inside of the chest. The camera transmits pictures to a monitor. Your doctor can also insert special instruments through the incisions to perform treatments. VATS lung surgery has revolutionized the treatment of many different lung diseases.

VATS is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having VATS.

Types of VATS

The types of VATS include:

  • Biopsy to take a tissue sample and examine it under a microscope to diagnose cancer and other diseases

  • Lobectomy to remove a large section of lung

  • Mediastinal procedures to treat problems of the area between the lungs (mediastinum)

  • Pericarial procedures to treat problems of the area around the heart (pericardium)

  • Sympathectomy to treat conditions related to the sympathetic nervous system

  • Thoracentesis to drain excess fluid from the area between the lungs and chest wall (pleural space)

  • Thymus procedures to treat problems of the thymus, a gland located in the chest

  • Wedge resection to remove a small portion of lung tissue

Your doctor may recommend video-assisted thoracoscopic surgery to treat a variety of chest and lung problems. Your doctor may only consider VATS for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your diagnostic and treatment options and consider getting a second opinion.

Your doctor may recommend VATS to diagnose or treat: 

  • Chronic conditions related to the sympathetic nervous system, including hyperhidrosis, Raynaud’s syndrome, and Buerger’s disease

  • Chest infections, including certain types of pneumonia

  • Empyema, a collection of pus in the area between the lungs and chest wall (pleural space)

  • Esophageal diseases, including GERD (gastroesophageal reflux disease) and problems with the esophageal muscles (achalasia)

  • Pleural effusion, a buildup of excess fluid in the air spaces and area between the lungs and chest wall (pleural space)

  • Pneumothorax, a collection of air or gas in the area between the lungs and chest wall (pleural space) that causes the lung to collapse

  • Trauma, including diaphragm injuries, airway injury, and foreign bodies

  • Tumors, including cancerous and noncancerous tumors of the lungs, esophagus, thymus, and chest cavity

Thoracic surgeons perform video-assisted thoracoscopic surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

Your VATS procedure will be performed in a hospital. VATS is a minimally invasive surgery. It involves inserting special instruments and a thoracoscope through at least two small incisions in your chest.

The thoracoscope is a thin, lighted instrument with a small camera. The camera sends pictures of the inside of your chest to a screen. Your surgeon sees the inside of your chest or lungs on the screen while performing surgery.

VATS generally involves a faster recovery and less pain than open chest surgery (thoracotomy). This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.

In some cases, your surgeon may combine VATS with an open surgery. In addition, your surgeon may decide after beginning VATS that you require thoracotomy to complete your surgery safely and effectively.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference.

You may already be in the hospital before your VATS procedure, depending on your condition. The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.

The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

As with all surgeries, video-assisted thoracoscopic surgery involves risks and complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

  • Anesthesia reaction, such as an allergic reaction and problems with breathing

  • Bleeding, which can lead to shock

  • Blood clot, in particular a deep vein thrombosis 

  • Infection 

Potential complications of VATS

Complications of VATS include:

  • Air leaking from the lungs

  • Chest pain

  • Damage to nerves or blood vessels

  • Failure of the lungs to expand

  • Lung injuries

  • Need for more surgery or open surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This may include cardiac rehabilitation.

  • Informing your doctor if you are nursing or there is any possibility that you may be pregnant

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. You can prepare for VATS by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), pulmonary function tests, blood tests, and other tests as needed.

  • Following dietary guidelines as directed

  • Losing excess weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and can help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need the VATS procedure? Are there any other options for treating my condition?

  • If you find a problem or another condition during surgery, will you treat it right away or will I need more surgery later?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

Knowing what to expect can help make your road to recovery after your VATS procedure as smooth as possible.

You will stay in the recovery room after surgery until your vital signs are stable. Your care team may move you to an intensive care unit (ICU). ICUs provide 24-hour specialized monitoring and care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids.

You will not be able to talk if you have a breathing tube. However, the care team usually removes it within 24 hours. You may have a sore throat from the tube. This is usually temporary, but tell your care team if you are uncomfortable.

You will have a chest tube to drain fluid and air while your lungs heal. The care team may remove the chest tube before you leave the hospital or you may still have it when you go home.

As you recover, you may move to a hospital room outside the ICU. Typically, hospital stays after VATS are 1 to 4 days.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. The care team will teach you how to use a spirometer and how to do deep breathing exercises. This will help you recover and avoid problems, such as pneumonia. Full recovery takes 2 to 6 weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after VATS. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Chest tube that comes out, moves out of position, or becomes cracked

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage, pus, redness or swelling of your incision

How might VATS affect my everyday life?

VATS can cure your chest or lung problem so you can lead a more active, normal life. It is normal to have numbness around your incisions. This is usually temporary and most people gradually regain normal feeling in their skin. This may take up to six months.

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Medical Reviewer: William C. Lloyd III, MD, FACS

Last Review Date: 2020 Nov 11

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Medically Reviewed By William C. Lloyd III, MD, FACS

Updated on November 11, 2020

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