Surgical Approaches to Thoracic Surgery

Overview

Depending on the complexity of the operation and the level of expertise of your cardiothoracic surgeon, different surgical approaches may be used.

Video-Assisted Thoracoscopic Surgery (VATS)

Video-Assisted Thoracoscopic Surgery (VATS)

This minimally invasive surgery is used to diagnose and treat a variety of conditions involving the chest area. During VATS, the cardiothoracic surgeon makes two to four incisions (about 1-3 centimeters long) on the chest wall. No rib spreading is needed. A thin, rigid tube with a special camera (thoracoscope) and other small tools are placed through these cuts, allowing the surgeon to see the inside of the chest on a TV monitor and to guide his/her tools. Once the surgery is completed, the incisions are closed with sutures and one or two chest tubes are used to drain the chest. Chest tubes are removed within 2 days after surgery. Because only small incisions are needed, you may have less bleeding, a lower chance of infection, less pain, a shorter hospital stay (typically 4 to 5 days), and a faster recovery.

Robotic-Assisted Thoracoscopic Surgery (RATS)

Robotic-Assisted Thoracoscopic Surgery (RATS)

Robotic-assisted surgery is another minimally invasive procedure. RATS allows the surgeon to operate through three to four small, half-inch incisions made between the ribs. No rib spreading is needed. A tiny 3D high-definition video camera is inserted into one of the incisions to give the surgeon a magnified, detailed view of the lung or inside of the chest. Surgical instruments are attached to robotic hands. The surgeon performs the operation while sitting at a console next to you. He/she uses hand and foot controls to guide the robotic hands, translating his/her movements into precise actions. This surgery can assist with hard-to-reach tumors. With RATS, you experience less pain and scaring, and recovery time is reduced.

Thoracotomy

Thoracotomy

A thoracotomy is a type of surgery that opens the chest. During this procedure, a surgeon makes an incision in the chest wall between two ribs, from front to back. The incision usually is 3-8 inches long and generally located on the side of your chest. Some muscle is cut and the ribs are spread apart. This type of surgery may be done for several reasons, not just the removal of cancer. Opening and exposing the chest cavity and mediastinum (the area between the lungs) can give surgeons access to the heart, lungs, esophagus, the upper part of the aorta, and the front part of the spine. A thoracotomy usually takes 3-4 hours, with a hospital stay of 5-10 days. Sometimes, smaller incisions under or near the armpit can be used. In these cases, the procedure is called a mini-thoracotomy.