Video Assisted Thoracoscopic Surgery (VATS) Lobectomy

A VATS (video-assisted thoracoscopic surgery) lobectomy is surgery to remove a lobe from your lung.

What is a VATS lobectomy?

Why do I need a VATS lobectomy?

What are the risks for having a VATS lobectomy?

How do I prepare for a VATS lobectomy?

What happens during a VATS lobectomy?

What happens after a VATS lobectomy?

What is a VATS lobectomy?

A VATS (video-assisted thoracoscopic surgery) lobectomy is a minimally invasive procedure to remove a lobe in the lung.

The surgery is performed through one to three small cuts, just a few centimetres long, in the side of your chest (as opposed to open-chest surgery).

Your surgeon will insert a camera through the one cut (approximately 4cm long) to see inside your chest during the surgery. The instruments needed to remove the lobe are inserted in the other smaller cuts.

The benefits of having a VATS lobectomy compared to the traditional open-chest surgery include:

 

  • A shorter hospital stay – as the cuts are very small, VATS does less damage to the body during the surgery and recovery is, on average, two days shorter than recovery from open-chest surgery

  • Less major complications – research suggests VATS is linked with less risk of an irregular heart rhythm (atrial fibrillation), collapsed lung (atelectasis), prolonged air leak, chest infections, kidney problems and overall pain

  • Less time needed with chest tubes in – chest tubes can be removed sooner provided the lung is healing well.

A VATS lobectomy usually takes 2-3 hours.

Why do I need a VATS lobectomy?

A VATS lobectomy is used to treat lung conditions such as:

 

  • Early stage lung cancer or growths

  • Inflammation of the lung

  • Severe lung infections.

 

Your doctor may recommend a VATS lobectomy if a shadow is found on your chest X-Ray or CT scan, as this can mean there is lung cancer.

 

A VATS lobectomy is an effective way to remove early-stage lung cancer.

 

Below, you can watch a short video from one of our doctors explaining more about a VATS lobectomy.

 

 

Below, you can watch an animation explaining what happens during a VATS lobectomy.

What are the risks for having a VATS lobectomy?

While risks and complications of VATS procedures are uncommon, there are some risks to be aware of. Your doctor will talk to you about the potential risks before your surgery.


Some of the possible risks can include:

 

  • Bleeding – some blood loss into your chest drains is normal, though if you are losing too much blood you may need further surgery

  • Changes to the surgery – if your doctor discovers that they can not perform your surgery using the VATS technique, they may need to use the traditional open-chest approach

  • Infection at the wound site – if you develop a chest infection, you may need physiotherapy and antibiotics (contact your doctor if you become unwell after the surgery and experience: fever, chest pain, coughing up blood, red or oozing wounds)

  • Pain – it is normal to feel pain after this surgery, and pain relief will be given

  • Prolonged air leak – a leak in the lung that can last more than seven days.

How do I prepare for a VATS lobectomy?

Around two weeks before your surgery, you’ll need to:

  • Be reviewed by a cardiologist – a specialist will check that your heart is safe for the surgery
  • Check with your doctor about taking your medications – you may need to stop taking some medications before your surgery, such as blood thinners; your doctor will talk to you about this
  • Have some important tests – you will need an ECG, chest X-ray, blood tests, lung function tests, cardiac stress test, and nose and groin swabs
  • Plan your transport home – it is your responsibility to arrange transport home; for information, including guidelines and tips for travelling home by car or plane after lung surgery, visit our travel page
  • Prepare your home for your return from hospital – make sure you have someone to collect you from hospital, take you home, and help you with shopping, meals, cleaning and driving   
  • Shower with antibacterial soap (from a chemist) daily before coming into hospital – your doctor will recommend a suitable soap brand for you
  • Stop smoking – speak to your doctor if you need help, or phone 13QUIT to get started.

If you take SGLT2 medicine for diabetes, you will need to stop taking them at least 3 days before your surgery; read our Patient Information Guide on SGLT2 inhibitors for diabetes.

On the day before surgery, you’ll need to:

  • Ensure your bowels are opened – ask your doctor for a laxative, if needed

  • Pack a small bag of essentials, like toiletries and glasses – your bag of essentials will be taken to the Intensive Care Unit after your surgery

  • Stop eating and drinking – you’ll need to fast from midnight before your surgery.

On the day of surgery:

  • A member of hospital staff will clip off any hair from your chest – this is done to reduce the potential of infection

  • Remember not to eat or drink anything – you’ll need to keep fasting, and talk to your doctor if you have any questions about this

  • Wear a hospital gown – you’ll also need to remove any makeup, nail polish and jewellery (dentures can be left in).

What happens during a VATS lobectomy?

During the procedure:

  • You will be given a general anaesthetic

  • Once you are asleep, a special breathing tube will be inserted down your windpipe

  • The tube keeps one lung oxygenated while the other lung is being operated on

  • The lung being operated on will be deflated, and the surgeon will make one to four small cuts on your chest to allow the removal of the lobe of the lung

  • Using video assistance, the veins and arteries that are attached to the lobe being removed are carefully divided and repaired with a special stapler

  • The lobe is then placed into a sterile bag and removed from the chest through one of the small cuts

  • After the lobe is removed, the surgeon re-inflates the lung, removes the instruments and camera, and closes the incisions.

What happens after a VATS lobectomy?

After your procedure, you will be taken to a Recovery Room or Intensive Care Unit in the hospital for close monitoring.


Once the staff are happy with your progress, you’ll be transferred to a hospital ward. During this time:

  • Your oxygen will need to stay on for at least the first few hours

  • Your chest drain normally stays in for 2-3 days, depending on the amount of chest drainage and whether there is an air leak

  • You may have a tube in your bladder to measure your urine (this is normally taken out the following morning after surgery).

While in hospital, you’ll see a physiotherapist regularly to help with your breathing, exercising, infection prevention and general recovery assistance.

Other points to be aware of as you recover in hospital include:

  • Breathing – you can expect to feel short of breath for 4-5 days after the operation as your lungs recover, but your breathing will improve

  • Eating and drinking – you will be able to eat and drink the day after your surgery

  • Pain relief – you’ll be given pain relief regularly, and hospital nurses will monitor your pain levels (tell them if you are still in pain after taking medication)

  • Showering – you will need help with showering to begin, and your hospital staff will assist with this.

Expect to stay in hospital for 3-5 days. Try not to compare yourself to others and don’t worry if you need longer.

When it’s time to leave hospital, your doctor and hospital staff will help ensure you have everything you need for a healthy recovery at home.

Here’s what you need to know about returning home after your VATS lobectomy:


  • Diet – it’s common to have a poor appetite initially, so stick to small frequent meals and make sure you have enough to drink

  • Driving – you will usually be able to drive 2-4 weeks after your surgery, but always check with your doctor first

  • Follow up appointments – you will need to make appointments to see your:

    • GP – one week after you leave hospital

    • Oncologist – two weeks after surgery

    • Surgeon – six weeks after surgery

  • Pulmonary rehab  – expect a fairly gradual recovery for the first few weeks (you’ll probably start feeling ‘normal’ around 4-6 weeks after surgery), and we encourage you to attend a pulmonary rehabilitation program to assist with your recovery

  • Rest – it’s normal to feel very tired for at least the first week, so try to have several rest periods during the day

  • Support – you will need someone to be at home with you for the first few days to help with anything involving lifting (shopping, washing, vacuuming, making beds)

  • Test results – the results from your tests will be available around one week after your surgery, and your doctor will contact you to discuss this

  • Work – you may need 2-4 weeks or longer off work, so discuss your work plans with your doctor and obtain a medical certificate if needed

  • Wound care – be aware of the following points:

    • Your wounds can take up to four weeks to heal

    • Your stitches will need to be removed 12 days after surgery by your GP

    • You may shower daily and get the wounds wet, but do not soak the wounds; gently pat your wounds dry and avoid using any creams or powders

    • You may have some numbness, tingling or pins and needles around your wounds for up to a few months

    • Some inflammation of the drain incision site is common. Antibiotics are given to you at the time of discharge from hospital to prevent infection.


   

If you notice your wounds becoming reddened or oozy, or if you have any concerns about your wound healing, please contact your GP or surgeon sooner rather than later.