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The use of video-assisted thoracic surgery (VATS), a minimally invasive procedure, has revolutionized thoracic surgery due to the decrease in post-operative pain, hospitalization and recovery time. Dignity Health’s minimally invasive surgery specialists most often use VATS for diagnoses of cancer and other pulmonary diseases by taking a wedge biopsy.
Generally 2-3 incisions of less than four centimeters are made along the chest wall, below the axilla (armpit). The incisions are made to allow the surgeon to work between ribs so no ribs are spread or removed.
The lung is deflated on the side of surgery so the surgeon has plenty of room to safely work in the chest cavity without injuring the lung or vessels. The other lung continues to ventilate and bring oxygen to the heart and body.
A small laparoscopic camera, grasping tools and the stapler instrument that takes the biopsy are inserted through the incisions. Once a wedge biopsy is taken, it is sent to pathology.
During the procedure, a pathologist (a physician who specializes in examining and diagnosing tissue in the body) will look at the tissue to determine if it is cancerous and, if so, to determine that the tissue margins are clear of cancer to prevent cancer tissue from being left in the lung. This is done during surgery so that if there is a positive margin, the thoracic surgeon will take more tissue until there is a clear (negative) margin.
After your video-assisted thoracic surgery, the pathologist will thoroughly examine all tissue removed during surgery and a definitive report will be sent to the thoracic surgeon and other participating physicians within 2-3 days.
Optimal definitive treatment in lung cancer is to completely remove the lobe that the cancer is located in; however, if a patient has low pulmonary function and will not tolerate removing a lung lobe, a VATS wedge with clear margins may be used to definitively treat lung cancer.
Most patients will stay in the hospital one night after a VATS procedure. Patients will have a chest tube after surgery, which will generally be taken out the next day. Any complications or more complex cases may require a hospital stay a few days longer.
Patients will follow up in their thoracic surgeon's office to review the full pathology report.