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VATS Offers Minimally Invasive Diagnosis and Treatment

By Robert J. Caccavale, MD, FACS, FCCP, and Jean-Philippe Bocage, MD, FACS, FCCP

Patients with lung cancer or other types of thoracic ailments don’t have to endure the painful and long recovery time often associated with a thoracotomy. A thoracotomy is a ten to 12 inch surgical incision of the chest wall, typically made on the right or left side of the chest between the ribs in order to access the heart or lungs during surgery. This type of surgery usually involves breaking or removing one or more ribs.

Robert Wood Johnson University Hospital Somerset offers a minimally invasive method to diagnose or treat thoracic conditions: video-assisted thoracic surgery (VATS). The procedure only requires four incisions, each less than an inch wide. During the operation, two surgeons working together insert a thin scope with a camera on its tip, called a thoracoscope, into the incisions. The camera projects an image of the contents of the chest cavity onto a video monitor. The enlarged, digital image allows the physicians to get a better view to and allows them to work between the chest muscles and avoid injury to the ribs and reduces trauma to the chest wall muscles. With video-assistance, surgeons are able to remove pathologic tissue of the lung and mediastimum and use a less invasive and traumatic surgery than was required in the past. VATS can also be used to diagnose pneumonia infections, infections or tumors of the chest wall, and treat collapsing lungs. Additional uses of VATS are continuing to be developed. The entire procedure typically lasts less than a half-hour, compared with an average of about two hours for a thoractomy.

A thoracotomy or traditional chest surgery often requires two months of healing and recovery. Conversely, almost all of our VATS patients do not require intensive care, can walk the same day, leave the medical center in about two days and can return to their normal routines in about seven to ten days. With VATS, the risks of complication are less than three percent, decreasing the chances for pneumonia, hypothermia and respiratory distress.

All chest surgeries at Robert Wood Johnson University Hospital Somerset are performed using the VATS technique, including intervention for cancers, lung abnormalities, infections and other problems affecting the chest cavity.

The most common thoracic conditions include lung malignancies and abnormalities, inflammatory lesions, infections and diseases of the mediastimum. Symptoms of a thoracic condition often include chest pain, a heavy cough, shortness of breath, wheezing and fatigue. If these symptoms persist for more than two weeks, see your physician. Your doctor may schedule a chest X-ray or a CT scan of the chest.

Individuals with a greater risk of developing a thoracic condition include people who smoke or are exposed to second-hand smoke and those with a family or personal history of thoracic ailments.

For a physician referral, call 1-888-MD-RWJUH (1-888-637-9584).

Robert Wood Johnson University Hospital Somerset surgeons Drs. Caccavale and Bocage were among the first in the world to perform Video-Assisted Thoracic Surgery and have successfully performed more than 6,000 surgeries using this technique.