happens when the test is performed?
- VATS is done in an
operating room. You wear a hospital gown and have an IV (intravenous)
line placed in your arm so that you can receive medicines through
VATS is usually done with general anesthesia, which puts you
to sleep so you are unconscious during the procedure. General
anesthesia is administered by an anesthesiologist, who asks you
to breathe a mixture of gases through a mask. After the anesthetic
takes effect, a tube is put down your throat to help you breathe.
Your anesthesiologist can use this tube to make you breathe using
only one of your lungs. This way the other lung can be completely
deflated and allow the surgeon a full view of your chest cavity
on that side during the procedure.
If VATS is being used only to evaluate a problem on the inside
of the ribcage (not the lung itself), then it can sometimes be
done using regional anesthesia. With regional anesthesia, you
are not asleep during the surgery, but are given medicines that
make you very groggy and that keep you from feeling pain in the
chest. This is done with either a spinal block or an epidural
block, in which an anesthesiologist injects the anesthetic through
a needle or tube in your back or neck. You do your own breathing
with this type of anesthesia, but one of your lungs will be partly
collapsed to allow the doctors to move instruments between the
lung and the chest wall.
You spend the surgery lying on your side. A very small incision
(less than an inch long) is made, usually between your seventh
and eighth ribs. Carbon dioxide gas is allowed to flow into your
chest through this opening, while your lung on that side is made
to partly or completely collapse. A tiny camera on a tube, called
a thoracoscope, is then inserted through the opening. Your doctor
can see the work he or she is doing by watching a video screen.
If you are having a procedure more complicated than inspection
of the chest and lung, the doctor makes one or two other small
incisions to allow additional instruments to reach into your
chest. These additional incisions are usually made in a curving
line along your lower ribcage. A wide variety of instruments
are useful in VATS. These include instruments that can cut away
a section of your lung and seal the hole left in your lung using
small staples, instruments that can burn away scar tissue, and
tools to remove small biopsy samples such as lymph nodes from
At the end of your surgery, the instruments are removed, the
lung is reinflated, and all but one of the small incisions are
stitched closed. For most patients, a tube (called a chest tube)
is placed through the remaining opening to help drain any leaking
air or fluid that collects after the surgery.
If you are having general anesthesia, it is stopped so that you
can wake up within a few minutes of your VATS being finished,
although you will remain drowsy for a while afterward.