What is VATS?

Video-Assisted Thoracoscopic Surgery is also known as VATS, and it is a type of a keyhole surgery where the surgeon makes a few small cuts (about 1cm each) in your chest. Through one of these cuts, a small camera will be inserted, showing live images on a computer screen which will help your surgeon to see inside your chest. Through the other cuts, the surgeon can insert tools to:

• Look at the lungs and chest lining, called the pleura.
• Take tissue samples (biopsies).
• Remove build-up of fluid.
• Treat a collapsed lung.

The VATS procedure is performed under general anaesthesia, which means that you will be asleep. One of the lungs may be temporarily deflated so that the surgeon can examine and operate on it. A special breathing tube placed in your mouth by the anaesthetist will help your other lung to continue to breathe for you.

When you come for your physical assessment appointment or on the day of your procedure, you will have a chance to talk to your surgeon and also to the anaesthetist and ask any additional questions you may have.

Why do I need a VATS?

During your initial consultation, your thoracic surgeon will discuss with you why a keyhole (VATS) procedure is the most appropriate option for you. For example, he may recommend VATS in order to:

• Check the chest lining (pleura) and take biopsies.
• Drain fluid build-up in the chest (pleural effusion).
• Treat a collapsed lung (pneumothorax).
• Remove lung tissue containing little air-filled pockets (also called bullae).
• Perform a procedure known as talc pleurodesis (see next).

What is talc pleurodesis?

Talc pleurodesis is a treatment aiming to stop the build-up of fluid or air in the space between the lung and the chest wall, also called the “pleural space”. To seal this space, the surgeon will use medical-grade talc, which causes irritation of the chest lining. This irritation will make the lung “stick” to the chest wall, sealing this space and preventing fluid or air from building up in the future.

Non-steroidal anti-inflammatory medications, for example Ibuprofen, should be avoided post-operatively, as they will inhibit the process of pleurodesis and may prevent the lung from sticking to the chest wall. Your nurses and doctors will be able to advise you on the most effective pain relief.

Will I have drains after the surgery?

You will likely have one or two chest drains positioned on the same side as your surgery. These drains can remove extra air, fluid or blood from the chest, and they will stay in place for 24–48 hours. Depending on how much fluid or air is coming out, the drains may need to stay in for a day or several days. The nurses and doctors on the ward will monitor the drains regularly and will let you know when the right time comes for the drains to be removed. After your surgery, you will also have one or more chest X-rays to check your lungs and help the doctors determine when the drains are ready to be removed.

What happens after surgery?

After VATS procedure, you are expected to stay in hospital for 2 to 3 days, but it can be longer if your recovery takes more time. Some possible problems that may happen after your surgery include:

• Air leaking from the lung
• Continuous fluid draining from inside the chest
• Bleeding
• Chest infection
• Infection at the wound site

What are the risks?

All treatments have some risks. Before signing your consent form, your surgeon will discuss with you the risks and benefits of the procedure, and you will have the opportunity to ask questions. The risks of having general anaesthesia will be explained to you by the anaesthetist on the morning of your surgery. If you have any concerns or queries about your procedure and the post-operative recovery, the specialist team of nurses and doctors remain available to you, and you will be given the relevant contact details during the pre-assessment process.

Further information

For more information and advice about your thoracic procedure, your hospital stay, the thoracic team and our enhanced recovery programme, please see our Thoracic Surgery Patient Information Page and Patient Diary. You can get in touch by calling us on 0203 456 6047 or by emailing us at uclh.ThoracicSurgeryCNS@nhs.net