VATS Lung Resection

VATS Lung Resection – What it is?

Keyhole lung surgery, or also known as Video-Assisted Thoracoscopic Surgery (VATS) is a less invasive technique for lung resection, and has become the standard of care as it helps to reduce postsurgery pain and aid in faster recovery.

Surgeons use a small camera and specialised tools inserted through tiny cuts in the chest. This approach reduces damage to surrounding tissues.

Why are VATS lung resections done?

Most commonly for early stage lung cancer: VATS lung resection is often used to treat early-stage lung cancer by removing the affected lobe and surrounding lymph nodes. This helps to treat cancer while preserving as much healthy lung tissue as possible.

Between 2013 and 2017, there were close to 8,000 lung cancers diagnosed in Singapore which was about four cases a day ⁽¹⁾. Lung cancer has a higher fatality rate as compared to breast or colon cancer; with more than three deaths a day. While smoking is found to be the main risk factor for lung cancer, there has been an increase in lung cancer for nonsmokers, especially in the Asian population.

Unfortunately in lung cancer, there are generally no symptoms during its early stages, and it is often only picked up through health screening or body check. Nonetheless, surgery can offer a good chance of cure if lung cancer is treated early.

How is VATS lung resection performed?

Traditionally, lobectomy (surgery to remove one of the lobes of the lung) or major resection of the lung is needed for treatment of lung cancer.

However, recent research ^(2-3) suggests a lesser resection for smaller lung cancer could result in equivalent cure rates and increase preservation of lung function.

The surgical team will help to assess if VATS lobectomy or sublobar resection is suitable. This will include blood tests, imaging scans and lung function tests, to ensure you are fit for surgery.  

(Barely visible wound after VATS.)

What can you expect going for VATS lung resection?

• Anaesthesia: You will receive general anaesthesia to ensure you are asleep and pain-free throughout the procedure. Most patient will only need minor pain relief upon discharge.
• Enhanced Recovery After Surgery (ERAS): Physiotherapy team will educate and support patients before and surgery. This is to help patients recover faster.
• Recovery time after VATS: most patients can expect to stay in the hospital for 3-5 days and resume normal activities and travelling after 2 weeks.
• Follow-up care: there will be follow-up appointments after surgery to ensure adequate recovery. The doctors will also assess if any additional cancer treatment is required after the final staging of cancer is confirmed then.
  

References

1. Singapore ICA Report on Registration of Births and Deaths 2019

2. Saji H, Okada M, Tsuboi M, Nakajima R, Suzuki K, Aokage K, Aoki T, Okami J, Yoshino I, Ito H, Okumura N, Yamaguchi M, Ikeda N, Wakabayashi M, Nakamura K, Fukuda H, Nakamura S, Mitsudomi T, Watanabe SI, Asamura H. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3,
randomised, controlled, non-inferiority trial. Lancet. 2022 Apr 23; 399(10335):1607-1617

3. National Comprehensive Cancer Network Guidelines for Non-Small Cell Lung Cancer 2021