Rather than the standard thoracotomy procedure which involves a large incision and rib spreading to allow access to the lungs, VATS can be utilized to either biopsy a lung lesion or treat known lung cancer through 2-4 cm incisions between the ribs.In addition to avoiding disruption to major structures typical with standard surgery, other VATS key benefits for your patients relate to pain following surgery, size of the incision, anesthesia and length of stay in the hospital (see table below). Additionally, long-term survival rates for VATS may prove better than open thoracotomy in the treatment of early stage non-small cell lung cancer.
Thoracotomy (Traditional) Versus VATS (Minimally Invasive)
These results are typical – your patients’ results may vary.
|Traditional||Minimally Invasive Surgery|
||Incisions and chest area may be painful for several weeks to months after surgery and sometimes longer||While pain in the hospital will still occur, it is usually less than experienced with a thoracotomy**|
||One large incision 10-15 cm||One main incision 4-6 cm (usually 4.5 cm); multiple additional incisions, typically 2-4 cm|
||Stages I-IIIA||Stages I-IIIA|
Length of Hospital Stay
||Up to 7 days||3-4 days|
In-Office Patient Materials
As the first of many doctors whom your patient may see, you play a vital role in helping direct them to resources that clarify their diagnosis and treatment options. Below, please find a series of materials that you can use with your patients to facilitate dialogue about their lung cancer diagnosis. Included in these materials is a with information for both you and your patients that serves as an overview of lung cancer, staging, treatment options and the VATS technique and benefits. The accompanying brochure is an abbreviated form of the booklet that features clear and easily understandable illustrations about treatment options.
Short video clips are available from a patient, Katie, who recently underwent VATS surgery. Thoracic surgeon, Michael Mulligan, M.D. from the University of Washington, also discusses the challenges of communicating a lung cancer diagnosis and addresses lung cancer treatment options including the benefits of VATS surgery.
Patients can also learn more about lung cancer treatment options or if necessary, find a VATS surgeon on the companion patient website.
Information Booklet for Patients
Information Brochure for Patients
View Katie, a lung cancer patient who recently underwent VATS surgery and her surgeon, Michael Mulligan, M.D., from the University of Washington
Understanding Lung Cancer Testimonial
These videos may contain graphic material that could be upsetting to some viewers; caution is advised.
VATS Research and Published Studies
The benefits of VATS over thoracotomy for early stage lung cancer are well documented. VATS has been shown to reduce post-operative pain, deliver a better immune system response,* provide a better chance of breathing normally and a better quality of life after surgery.
- Cattaneo, S. et al. Use of Video-Assisted Thoracic Surgery for Lobectomy in the Elderly Results in Fewer Complications. Ann Thorac Surg, 2008; 85: 231-6.
- Enewold, L. et al. Serum Concentrations of Cytokines and Lung Cancer Survival in African Americans and Caucasians. Cancer Epidem Biomar, January, 2009.
- Mack, M. Minimally Invasive and Robotic Surgery. JAMA, 2001.
- McKenna, R., Jr. et al. Video-Assisted Thoracic Surgery Lobectomy: Experience with 1,100 Cases. Ann Thorac Surg, 2006; 81: 421-6.
- Ohtsuka, T. Is Major Pulmonary Resection by Video-Assisted Thoracic Surgery an Adequate Procedure in Clinical Stage I Lung Cancer? CHEST, May, 2004.
- Onaitis, M. et al. Thoracoscopic Lobectomy is a Safe and Versatile Procedure. Ann Surg, September, 2006.
- Subroto, P. et al. Thoracoscopic Lobectomy is Associated with Lower Morbidity Than Open Lobectomy: A Propensity-Matched Analysis From the STS Database. J Thorac Cardiovasc Surg, February, 2010; 139: 336-378.
- Walker, W. et al. The VATS Lobectomist: Analysis of Costs and Alterations In the Traditional Surgical Working Pattern In the Modern Surgical Unit. Thorac Surg Clin, August, 2008.
- Whitson, B. et al. Surgery for Early-Stage Non-Small Cell Lung Cancer: A Systematic Review of the Video-Assisted Thoracoscopic Surgery Versus Thoracotomy Approaches to Lobectomy. Ann Thorac Surg, December, 2008.
*VATS is associated with reduced cytokine production. Cytokines regulate the immune system and certain cytokines associated with the body’s inflammatory response have been linked to a better lung cancer prognosis when they are at lower levels.
**Occasionally, patients can suffer longer term pain; however, current data indicates that two-thirds of patients do not require major pain management beyond 3 weeks.