What is VATS?
VATS (Video-Assisted Thoracoscopic Surgery) is a chest surgery using a small camera and specialized instruments inserted through small incisions about 1–3 centimeters in 2–3 locations, instead of a long incision as in traditional chest surgery.
The camera image is displayed on a screen, allowing the surgeon to clearly see the internal structures of the chest and to remove cancerous tumors or lung lobes (Lobectomy) along with lymph node dissection according to treatment standards.
Who is suitable for lung cancer surgery with VATS?
Generally, doctors consider patients who
- have early-stage lung cancer (Stage I or some cases in Stage II)
- have tumors of appropriate size and location
- have no significant spread
- have sufficient lung and heart function for surgery
The decision requires test results such as CT Scan of the lungs, PET-CT, biopsy results, and overall health assessment
How to assess “lung function” before surgery?
Before deciding on lung cancer surgery, doctors do not only look at tumor size or disease stage but must evaluate how well the patient can live after partial lung removal.
Important tests include Pulmonary Function Test (PFT) to measure lung function, assessment of FEV1 and DLCO and calculation of the “expected remaining functional lung volume” after surgery
If lung function is too low, doctors may consider other options such as targeted radiation therapy (SBRT) instead of surgery. This is why treatment choice is not about “small or large incision” but about the patient’s long-term safety
How is VATS different from open surgery?
| Comparison Topic | VATS | Open Thoracotomy |
| Incision size | Small | Long incision |
| Muscle trauma | Less | More |
| Hospital stay duration | May be shorter (in some cases) | Longer |
Note: Results depend on patient condition and physician’s discretion
VATS Surgery Steps
- General anesthesia
- Make 2–3 small incisions
- Insert camera and instruments
- Remove cancerous tumor or lung lobe, along with lymph node dissection
- Insert temporary chest drainage tube
After surgery, patients receive close care for breathing, lung expansion, and rehabilitation.
Q&A: How long is the recovery period?
Generally, patients may start walking within 1–2 days after surgery, stay in hospital about 3–5 days (depending on each case) and return to daily activities as advised by the doctor. Recovery time varies individually.
Regarding recovery, factors affecting post-surgery recovery (more than incision size) Many believe recovery depends only on incision size, but in practice it also depends on age and comorbidities such as diabetes, heart disease nutritional status quitting smoking before surgery and pulmonary rehabilitation after surgery, etc. Therefore, the term “fast recovery” differs for each individual.
Q&A: What are the risks of lung surgery with VATS?
Although it is a minimally invasive technique, it is still major surgery and may have risks such as
- Bleeding
- Air leak in the lung
- Infection
- Complications from general anesthesia
Thorough preoperative evaluation helps reduce risks.
Q&A: Can VATS technique be used for lung cancer surgery at all stages?
- Not all cases; disease stage and spread must be evaluated
Q&A: Is chemotherapy required after surgery?
- Depends on biopsy results and disease stage after surgery
Q&A: Can elderly patients undergo surgery?
- Age is not an absolute contraindication; overall health must be assessed
Lung cancer surgery using the VATS technique is another treatment option for suitable patients, helping reduce tissue trauma and supporting quality of life after surgery under the care of a specialized medical team. If you experience abnormal symptoms such as chronic cough, coughing up blood, difficulty breathing, or belong to a risk group, you should be evaluated by a doctor to plan the most appropriate treatment.
