Video-Assisted Thoracoscopic (VATS) Wedge Resection with Brachytherapy
The University of Wisconsin Carbone Cancer Center in Madison, Wisconsin, offers a new technology for the treatment of high risk lung cancer patients called Video Asisted Thoracoscopic Surgery (VATS) wedge resection with brachytherapy.
The Challenge of Lung Cancer
Treating lung cancer patients can be particularly challenging because patients may not be suitable candidates for surgery. VATS wedge resection with brachytherapy offers an effective alternative to conventional "open" thoractomy.
The UW Carbone Cancer Center is currently the only facility in Wisconsin to perform totally minimally invasive VATS wedge resection with brachytherapy procedure for high risk patients with stage I non-small cell lung cancers smaller than 3 cm.
UW Carbone Cancer Center physicians has been performing VATS lobectomies since 1997 and the UW Carbone Cancer Center continues as a national leader in researching and embracing new, minmally invasive technologies to diagnose and treat lung cancer.
From Our Surgeons: Ryan Macke, MD
The standard approach to addressing early lung tumors is to perform a lobectomy, removal of an entire lobe of the lung. In the past decade, the use of computed tomographic (CT) scan screening has made it possible for physicians to detect every smaller non-small cell lung cancers. Therefore, removal of an entire lobe of the lung may not always be necessary. The removal of only a small slice of one lobe may be the best option for some patients.
Those and other patients may be candidates for the VATS wedge resection procedure, which removes a much smaller amount of lung tissue and can be combined with brachytherapy, a type of radiation therapy.
Many patients opt to have radiation treatment done as part of the VATS wedge procedure since the side effects are low.
The VATS Wedge with Brachytherapy Procedure
The surgery takes about three hours. With the patient under general anesthesia, surgeons make three small incisions (from 5-15mm) in the patient's chest and side. The small incisions are used to insert a thoracoscope and other surgical instruments used during the procedure.
Using video assistance, surgeons remove a small, triangle-shaped slice from the lung and the mediastinal lymph nodes. Another UW Carbone Cancer Center physician then does brachytherapy, which uses radioactive "seeds" to treat effectively a much wider area of tissue. The seeds are sewn onto a mesh, which is folded over the exposed area where the wedge of lung tissue has been removed. By combining the surgery and brachtherapy, patients receive the care they need in one day, avoiding 5 to 6 weeks of hospital visits typical of the traditional radiation therapy follow up.
Results Following a VATS Wedge with Brachytherapy Procedure
Recovery following a VATS wedge procedure generally requires a hospital stay of two to four days followed by about a week at home. Patient can usually return to work within two weeks. Traditional open chest surgery requires a hospital stay of five to seven days with a recovery period at home of up to a month or longer. Since the ribs are not stretched during the minimally invasive procedure, there is much less pain as well as a faster recovery period for the patient.
The procedure is safe for useon patients of any age, but is not recommended for patients who are considering having children in the next three years.