This is a limited surgical procedure where a small incision is made in the chest wall. A scope (thoracoscope) is inserted into the chest cavity so the surgeon can directly visualize the lining of the chest wall and the surface of the lungs. Biopsies can then be obtained.

VATS (Video-Assisted Thoracic Surgery)
Vats is a type of thoracoscopy, although it is a newer “minimally invasive” technique, where 1-2 additional incisions are made. A video camera is within the scope. The scope is inserted through one of the incisions and the lung is deflated. The biopsy is taken with other instruments inserted through the additional incisions. In some patients, a wedge of the lung or an entire lobe may be removed.

Either of these procedures requires general anesthesia and insertion of a chest tube, which reinflates the lung after the procedure is done. It will require hospitalization for at least 24-48 hours.

Preparation
You may not have anything to eat or drink after midnight the night before the procedure. You will come to the hospital the morning of the procedure. You will have an IV placed in your arm so that medications to put you to sleep can be given.

Advantages
Advantages to a thoracoscopic chest biopsy include knowing if the preliminary results are positive for cancer the day of the procedure. The final pathology report will take up to 3-5 working days.  A VATS done to remove a lobe of the lung offers a shorter recovery time with less pain as compared to an open lung procedure (thoracotomy).

Disadvantages        
Occasionally a VATS for removal of part of the lung fails and the procedure is converted to an open procedure (thoracotomy).

Possible Risks

• Bleeding
• Infection
• Air leak from the lung through the chest tube site, which may require added days in the hospital

What to expect after the procedure
You will have pain from the incision sites as well as from the chest tube. The chest tube will be removed as soon as your lung has fully expanded (12-72 hours) and no air leaks from the lung. You will possibly go home with sutures that will need to be removed in a week. You will need to keep the incision and chest tube sites clean and dry. You may shower as soon as the sutures are removed.

WHAT TO REPORT TO YOUR PHYSICIAN

1. Increased shortness of breath
2. Chest pain
3. Fever more than 101 degrees
4. Redness or drainage around the incision or chest tube sites