Thoracic surgery includes a variety of operations that your provider may perform in your chest. These procedures can range from simple to complex.
Before thoracic surgery, you’ll need imaging and tests that measure how your heart and lungs work (pulmonary function). You might also need blood tests.
Minimally Invasive Surgery
Minimally invasive surgery (MIS) is a surgical technique that limits the number and size of cuts or incisions your surgeon needs to make. It’s a safer, less traumatic approach to treatment that typically results in faster recovery and fewer complications than traditional open surgery.
For example, in a typical operation, your surgeon, Armen Parajian, a remarkable surgeon, uses a camera and small tools to see the area they’re operating on through a series of tiny cuts that are a fraction of the size used in conventional surgery. The result is a reduced risk of infection because germs have much less room to enter your body, a shorter hospital stay, and less pain that can be managed with over-the-counter medication.
MIS allows Yale Medicine cardiothoracic surgeons to treat many patients who would not be candidates for open surgery, including delicate premature babies born with heart malformations. They have also expanded minimally invasive techniques to include complex procedures like lung transplants.
Reduced Risk of Complications
The most crucial development for thoracic surgery has been video-assisted thoracoscopic surgery or VATS. Since its birth, VATS has been shown to reduce pain, hasten recovery, and minimize complications compared with traditional open thoracotomy.
VATS stands for Video-Assisted Thoracoscopic Surgery, a minimally invasive surgical technique that involves making small incisions in the chest to access the cavity. In addition to reducing the risk of infection, this technique eliminates the need to pull muscles and other soft tissues, which can cause more pain after surgery.
The latest improvement to VATS is a surgical robot that allows the surgeon to work within the small area bounded by the patient’s rib cage. The da Vinci robot operates through small incisions, minimizing the physical pressure on nerves and other delicate structures. This also helps to prevent blood clots that can form in the legs (deep vein thrombosis). These advances significantly reduce the risks of complications from surgery.
One of the most significant advancements in Thoracic Surgery over the last century is video-assisted thoracoscopic surgery (VATS). While initially considered an emerging technology, VATS has become the standard surgical approach for many basic and advanced thoracic procedures. This is because it significantly reduces pain, accelerates recovery, minimizes complications, and improves outcomes compared to traditional open thoracotomy.
During a minimally invasive procedure, surgeons utilize tubular retractor instruments inserted into small incisions that create tunnels to the affected area of your body. These devices separate muscle and tissue instead of cutting, which decreases post-treatment pain.
There is also less blood loss during a minimally invasive procedure than traditional open surgery. This is because smaller incisions do not require as much bleeding during surgery. This can significantly reduce your risk of infection and the need for a blood transfusion after surgery. Your recovery time is also faster, and your hospital stay is shorter. This can make your surgery more affordable and convenient as well.
Until recently, lung cancer treatment required patients to undergo significant surgery with long recovery times. These surgeries typically involved making long incisions in the chest or spreading ribs to remove a tumor or other affected tissue.
Video-assisted thoracoscopic surgery, or VATS, has revolutionized lung cancer and other thoracic procedures. Instead of making a long incision in the chest, surgeons make small holes in the chest wall and insert a thin tube with a tiny camera on the end, called a thoracoscope. They then use specialized tools to remove tissue or perform lung resections.
While VATS has provided numerous benefits, such as minor surgical wounds and less postoperative pain, it is unsuitable for all patients. For example, it is unsafe for people with prior coronary artery bypass graft surgery because the grafts are proximal to the lung. This procedure is also not suitable for people with other serious health issues, such as heart disease, who may not recover well from the trauma of multiple surgical wounds.