Type of Surgery
Information
Last updated: 02/17/2009
Video-assisted thoracic surgery (VATS) is a less invasive alternative to thoracotomy. Also called thoracoscopy, VATS involves the insertion of a thoracoscope (a thin, lighted tube) into a small incision through the chest wall. The surgeon can...
visualize the structures inside the chest cavity on a video screen. Such instruments as a stapler or grasper may inserted through other small incisions. Although initially used as a diagnostic tool (to visualize the lungs or to remove a sample of lung tissue for further examination), VATS may be used to remove some lung tumors.
An alternative to emergency thoracotomy is a tube thoracostomy, a tube placed through chest wall to drain excess fluid. Over 80% of patients with a penetrating chest wound can be successfully managed with a thoracostomy.
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Other Information
Thoracotomy is an incision into the chest. It is performed by a surgeon, and, rarely, by emergency physicians and paramedics, to gain access to the thoracic organs, most commonly the heart, the lungs, the esophagus or thoracic aorta, or for access to the anterior spine such as is necessary for access to tumors in the spine.
Thoracotomy is a major surgical maneuver—the first step in many thoracic surgeries including lobectomy or pneumonectomy for lung cancer—and as such requires general anesthesia with endotracheal tube insertion and mechanical ventilation.
Thoracotomies are thought to be one of the hardest surgical incisions to deal with post-op, because they are exquisitely painful and the pain can prevent the patient from breathing effectively, leading to atelectasis or pneumonia.
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