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Video-Assisted Thoracoscopic (VATS) Lobectomy
Related Conditions
The University of Wisconsin Paul P. Carbone Comprehensive Cancer Center in Madison, Wisconsin, offers a minimally invasive way to perform lobectomies. This procedure, called video-assisted thoracoscopic (VATS) lobectomy, uses small incisions, special instruments and a magnifying video camera.
VATS lobectomies are best used to treat patients with small, stage I lung cancer tumors. Patients who have large tumors (greater than five centimeters), visible tumors inside the main airway of the lung, or whose cancer has spread to other parts of the body, may not be eligible for VATS lobectomy.
UW Health surgeons have been performing VATS lobectomies since 1997. Our thoracic surgeons have advanced oncologic and minimally invasive training and outstanding results performing this technically challenging procedure.
When performed on eligible patients, the VATS lobectomy procedure can effectively treat early-stage lung cancer and also offer patients a shorter hospital stay, less pain after surgery and a faster recovery time.
The Video-Assisted Thoracoscopic (VATS) Lobectomy Procedure
The VATS lobectomy procedure takes approximately three hours. Patients will be asleep during surgery. First, an anesthesiologist inserts a tube into the trachea (the airway from the mouth to the lungs). This helps patients breathe during the operation.
The surgeon then makes two five millimeter incisions and one 10 millimeter incision on one side of the chest between the ribs. The surgeon inserts ports into these incisions to hold the instruments and video camera.
A small video camara is then inserted through one of the ports. Using the video as a guide, the surgeon inserts tiny instruments into the other ports. The surgeon then uses staples to seal off the blood vessels that connect to the lobe to be removed. The lobe is then separated from the main airway of the lung. Using more staples, the surgeon seals the remaining tissue.
The lobe is then placed into a bag and removed from the chest through one of the incisions. The lobe is placed into a bag that prevents cancerous tumor from "seeding" the wound as it is extracted. After the lobe is removed, the surgeon removes the instruments and video camera, and closes and bandages the incisions. The end result is a few small incision scars on the chest.
The lobe is then placed into a bag and removed from the chest through one of the incisions. The lobe is placed into a bag that prevents cancerous tumor from "seeding" the wound as it is extracted. After the lobe is removed, the surgeon removes the instruments and video camera, and closes and bandages the incisions. The end result is a few small incision scars on the chest.
What to Expect after Surgery
After surgery, patients are moved to the recovery area. The breathing tube that was inserted during the operation will have been removed in the operating room. In general, patients go to the regular floor after a brief stay in the recovery room.
Most patients stay in the hospital three to four days after surgery. While patients are in the hospital, staff follow their progress with chest x-rays and remove chest tubes once the lungs have healed.
Most patients have short-term pain and tenderness around the surgical sites and take pain medication for three to four weeks after surgery. We will check whether the cancer returns at follow-up visits. Patients are allowed to resume normal physical activity once they are no longer taking pain medications.
Video-Assisted Thoracoscopic (VATS) Lobectomy Results
Studies show that VATS lobectomy is a safe, effective treatment for treating Stage I lung cancer. In one recent study, patients who underwent VATS thymectomy had the following results:
- Complication rate: nine percent
- Conversion rate: 10 percent (Conversion means that the operation was converted from minimally invasive to traditional open lobectomy.)
- Death rate: one percent
In addition, this study also showed that patients who underwent VATS lobectomy had a three-year survival rate of 93 percent. (Ohtsuka T et al. Is major pulmonary resection by video-assisted thoracic surgery an adequate procedure in clinical stage I lung cancer? Chest, May 2004;125:1742-1746.)
In another study, the three-year survival rate for VATS lobectomy patients was between 71.1 percent and 83.5 percent, depending on the type of cancer being treated. This same study showed five-year survival rates to be between 56.1 percent and 76.2 percent. (Roviaro G et al. Long-term survival after videothoracoscopic lobectomy for stage I lung cancer. Chest, Sep 2004;126: 725-732.)