Minimally Invasive Thoracic Surgery
Background
Minimally invasive thoracic surgery is lung and chest surgery performed through small incisions. It is performed using a thorascope (a camera on the end of a long tube that is inserted through a small incision so the surgeon can see inside the chest), and either specialised, long instruments (commonly called video-assisted thoracic surgery or VATS), or a surgical robotic system.
There are a number of types of lung surgery that can be performed with this technique including:
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Wedge resection: a wedge-shaped portion of lung tissue cut out and removed using specialised staplers. Commonly performed for the diagnosis or treatment of small lung nodules.
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Lobectomy: The lungs are made of five lobes, three on the right and two on the left. One (or sometimes two) of the affected lobes is removed and the rest of the lung tissue can continue to work as normal.
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Pneumonectomy: An entire lung is removed, along with its airway and its blood vessels. This is commonly done for cancers that have affected more than one lobe of the lung.
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Pleurodesis: Talc powder is put into the pleural space causing the lung to stick to the chest wall to prevent the accumulation of fluid or air in the space around the lung.
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Pleural biopsy: A pleural biopsy removes a tissue sample from the membrane that lines the inside of the chest wall.
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Video-assisted thoracic surgery (VATS): Small incisions are made in the chest wall which are about one to five centimetres in length. A lighted scope and other surgical instruments are put through these small cuts to enable surgery to be performed on the lung and the pleura (the lining of the chest cavity). There is no rib spreading and so recovery can be faster.
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Thoracotomy: An incision is made on the side to back of the chest approximately five to ten centimetres long, then the ribs are spread to enable entry into the chest cavity.
Wedge Resection
Pneumonectomy
Lobectomy
Benefits of minimally invasive surgery
Compared to traditional, open thoracic surgery, minimally invasive surgery results in:
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Smaller incisions and better cosmetic result
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Less bleeding and risk of infection
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Less pain after the operation
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Shorter hospital stay
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Faster recovery and return to work
Recovery period
The length of your hospital stay will depend on the procedure that is performed. In general, patients who have thoracoscopic lung biopsies or wedge resections are able to go home the day after surgery. Patients who have a VATS lobectomy are usually able to go home three to four days after surgery.
Risks of the surgery
Your surgeon will calculate your risks specific to you, and discuss them with you.
All patients should consult their cardiothoracic surgeon for specific information about their medical condition and surgery.
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