Kenya’s Aga Khan University Hospital has launched Video Assisted Thoracic Surgery (VATS) to enable doctors operate inside the chest cavity with the help of 5 mm or 10 mm telescopes and instruments.
VATS treatment will help in diagnosing cancer, infections, TB, lung fibrosis, tumours of the chest wall, draining fluid around the heart and lungs and treating repeatedly collapsing lungs.
Dr Raj Jutley, Director, Cardiac Surgery at the Aga Khan University Hospital, said, “This test is carried out under general anesthesia and a tube is put down the throat to help the patient breathe through one lung. This way the other lung is completely deflated and allows the surgeon to fully view the chest cavity during the procedure.”
VATS surgery is not as complicated.
A patient lies on one side, a 10 mm incision is made between the ribs and the 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. The doctor can see the work he or she is doing by watching a video screen. If a patient is 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 the chest.
A wide variety of instruments are used during VATS surgery such as those that can cut away a section of the lung and seal the hole left in the lung using small staples, apparatus which can burn away scar tissues and tools to remove small biopsy samples such as lymph nodes from the chest.
Then, after the surgery, the instruments are removed, the lung is re-inflated and all 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.
“It is easier for patients to recover from VATS procedure compared to regular chest surgery (often called ‘open’ surgery) because the wounds from the incisions are much smaller and there is no spreading of the ribs. You will have a small straight scar (less than an inch long) where the instruments were inserted, said Dr. Jutley.
“Sometimes, especially if cancer is diagnosed, doctors will decide whether a larger surgery is needed to treat the disease. If necessary, doctors can change over to a larger incision and do open chest surgery while the patient is still under anesthesia,” he concluded.