Lung Cancer: Video-Assisted and Robotic-Assisted Thoracic Surgery

If you have lung cancer, your surgeon may advise you to have surgery to treat it. This is called a lung resection. During the surgery, the surgeon removes part or all of your lung.

Having surgery can be scary. But you may be able to have surgery that is minimally invasive. This type of surgery uses several small incisions between the ribs instead of 1 big incision (open surgery). And the surgeon does not have to separate the ribs like with open surgery. The surgeon puts small tools and a tiny camera into the small incisions. There are 2 types of minimally invasive surgery used for lung cancer. They are called video-assisted thoracic surgery (VATS) and robotic-assisted thoracic surgery (RATS).

What is video-assisted thoracic surgery (VATS)?

Video-assisted thoracic surgery (VATS) is a way to do surgery with only a few small cuts. The surgeon inserts a small tube (thoracoscope) with a tiny camera at the end that sends an image to a screen. The surgeon uses this video feed to guide special tools. You will have general anesthesia, so you are asleep and don’t feel pain. A breathing tube is placed in your airway to help you breathe. The surgeon may remove lung tissue, lymph nodes, and fluid. You may have a tube in your chest after surgery. This is to drain air and fluid. It is usually taken out before you go home. You will likely stay in the hospital for a few days.

Benefits of VATS

If you have VATS to treat your lung cancer, here's what you can expect:

• Less pain. Smaller cuts mean you will hurt less after surgery.

• Shorter hospital stay. You can likely go home in a few days.

• Faster recovery. You can get back to your normal life sooner than with open surgery.

• Less scarring. The small cuts leave smaller scars.

What is robotic -assisted thoracic surgery (RATS)?

Robotic-assisted thoracic surgery (RATS) also uses small cuts. Small tools and a camera are placed into the small incisions. The robotic tools are controlled by the surgeon through a special device. The closer camera view and the special robotic tools can help the surgeon be more precise. This can be helpful for more complex surgery. You will have general anesthesia, so you are asleep and don’t feel pain during the surgery. A breathing tube is placed in your airway to help you breathe. The surgeon may remove lung tissue, lymph nodes, and fluid. You may have a tube in your chest after surgery. This is to drain air and fluid. It is usually taken out before you go home. You will likely stay in the hospital for a few days.

Benefits of RATS

If you have RATS to treat your lung cancer, here's what you can expect:

• Better accuracy. The robotic surgery system helps the surgeon be more exact. That can lead to better results.

• Less pain. You will have less pain after surgery because the cuts are small.

• Shorter hospital stay. You can likely go home in a few days.

• Less scarring. The small cuts leave smaller scars.

Who can have VATS or RATS?

You may be able to have VATS or RATS depending on:

• The type, size, and location of the cancer

• Your overall health

• Your treatment history

Choose a surgeon who has a lot of experience in the type of surgery you need. Make sure the surgeon and care center have experience in VATS or RATS. Not all hospitals have the robotic equipment needed for RATS.

Possible complications

Both VATS and RATS work well for treating some people with lung cancer. But any surgery can have complications. Talk with your surgeon about the risks of your treatment and what symptoms you should report. Complications may include:

• Infection

• Blood clots

• Bleeding

• Collapsed lung

• Reaction to anesthesia

• Abnormal heart rhythm

Recovery after surgery

After VATS or RATS, you'll get instructions for how to take care of yourself. You will learn about:

• Managing pain. Your provider will prescribe or suggest pain medicines and methods to help reduce pain.

• Breathing exercises. You’ll learn breathing exercises. These are to help your lungs heal and prevent problems like pneumonia.

• Limits on activities. You'll need to not do strenuous movements or heavy lifting for a few weeks. Your healthcare team will tell you when you can drive, bathe, and do more activity.

• Incision care. You’ll learn how to take care of any incisions and dressings at home.

• Follow-up appointments. You'll see your surgeon for regular checkups after your surgery. These are to make sure you’re healing well. Your provider will watch for any signs the cancer might come back.

Your healthcare team is there to help you. Ask any questions you have and talk about your concerns. This will help you make the best decision for your situation. With the right information and care, you can work together to fight lung cancer and move toward a healthier future.