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by Stahl RJ


VATS is a type of chest surgery that requires making tiny openings in the chest. During VATS, the doctor makes small, keyhole incisions and uses a tiny camera (called a thoracoscope) and other small tools. Images from the camera are sent to TV monitors. The doctor relies on these images to do the surgery.

Reasons for Procedure

VATS is used to diagnose and treat a range of conditions. Common reasons to undergo VATS include:

  • Diagnosing and treating lung cancer , including lymph node biopsy
  • Removing diseased lung sections or lobes
  • Diagnosing lung infections
  • Treating a collapsed lung— atelectasis
  • Draining fluid out of the chest cavity
  • Diagnosing and treating of the thymus gland
Lung Cancer
Copyright © Nucleus Medical Media, Inc.

Compared to traditional procedures, VATS may result in:

  • Less pain and faster recovery
  • Shorter hospital stay
  • Fewer complications
  • Less scarring

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Infection
  • Bleeding
  • Anesthesia-related problems
  • Air leaking from the lungs or collapsed lung.
  • Chest pain
  • The need to switch to open chest surgery

Some factors that may increase the risk of complications include:

  • Pre-existing heart or lung condition
  • Smoking
  • Obesity
  • Diabetes
  • Previous chest surgery
  • Use of certain medications

What to Expect

Prior to Procedure

Depending on the reason for your surgery, your doctor may do the following:

  • Physical exam and blood tests
  • Pulmonary function tests —to help the doctor determine how well your lungs are functioning
  • CT scan
  • ECG —to evaluate the electrical activity of the heart
  • Tests to evaluate how well the heart is functioning

Leading up to the surgery:

  • Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.
  • Arrange for someone to drive you home.
  • Arrange for help at home during your recovery.
  • Eat a light meal the night before. Do not eat or drink anything after midnight.


General anesthesia will be given—you will be asleep during the procedure

Description of the Procedure

You will be connected to a ventilator. This is a machine that moves air in and out of your lungs. Depending on the reason you are having VATS, one lung will be completely or partly deflated. This will allow your doctor to have a better view of the chest cavity on that side.

Several small cuts in the skin will be made along your side. Carbon dioxide gas will be used to fill the chest cavity. The gas will make it easier for the doctor to see internal structures. Through one of the incisions, the doctor will insert the thoracoscope. This camera will send images to the TV monitors. The doctor will rely on these images to do the surgery. Other small tools will be inserted into the cuts. These tools will allow the doctor to grasp, cut, dissect, and suture.

When the surgery is done, the tools will be removed. The lung will be inflated. A chest tube will be placed to drain any air or fluid. The doctor will close the incisions with sutures or staples.

Immediately After Procedure

If you are doing well, the breathing tube will be removed. In the recovery room, the hospital staff will monitor your vital signs. You may be given fluids and medications through an IV.

How Long Will It Take?

1-2 hours (depending on the procedure)

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay

You may be able to go home the next day. If you have VATS for a lobectomy (removal of part of the lung), the usual length of stay is 3-4 days.

Post-procedure Care

At the Hospital

While you are recovering at the hospital, you may receive the following care:

  • Assistance sitting up and moving around soon after surgery.
  • Directions on how to do deep breathing and coughing exercises—You will learn how to use an incentive spirometer. This device helps you expand your lungs when taking a deep breath.
  • Chest x-rays to monitor healing—The drainage chest tubes will be removed once your lungs are healed.
  • Instructions about nutrition and physical activity
Preventing Infection

During your stay, the hospital staff will take steps to reduce your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to reduce your chance of infection such as:

  • Washing your hands often and reminding your healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incision
At Home

You will need to limit specific activities, but encouraged to walk daily. Follow instructions on wound care to prevent infection. Your doctor may advise pain medications to relieve discomfort. You may need to continue with deep breathing exercises to keep your lungs clear.

Call Your Doctor

Call your doctor if any of these occur:

  • Cough or shortness of breath
  • Coughing up yellow, green, or bloody mucus
  • New chest pain
  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from an incision site
  • Pain and/or swelling in your feet, calves, or legs
  • Persistent nausea, vomiting, or diarrhea
  • New or unexpected symptoms

Call for emergency medical services right away for:

  • Sudden chest pain
  • Sudden shortness of breath

If you think you have an emergency, call for emergency medical services right away.


American Thoracic Society  http://www.thoracic.org 

The Society of Thoracic Surgeons  https://www.sts.org 


Canadian Society for Vascular Surgery  https://vascular.ca 

The Lung Association  https://www.lung.ca 


Post-operative minimally invasive (robotic or thoracoscopic) lung surgery instructions. University of Southern California Division of Surgery website. Available at: http://www.surgery.usc.edu/thoracic/downloads/usc-minimally%5Finvasive%5Flung%5Fsurgery%5Fjanuary2017.pdf. Accessed March 27, 2018.

Video-assisted thoracic surgery. Harvard Health Publications website. Available at: https://www.health.harvard.edu/diagnostic-tests/video-assisted-thoracic-surgery.htm. Updated August 2014. Accessed March 27, 2018.

Video-assisted thorascopic surgery (VATS). Rush University Medical Center website. Available at: https://www.rush.edu/services/test-treatment/video-assisted-thoracoscopic-surgery-vats. Accessed March 27, 2018.

6/2/2011 DynaMed Plus Systematic Literature Surveillance  https://www.dynamed.com/topics/dmp~AN~T905141/Treatment-for-tobacco-use  : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.

Revision Information

  • Reviewer: EBSCO Medical Review Board Donald W. Buck II, MD
  • Review Date: 03/2018
  • Update Date: 06/20/2013