SURGERY BY VIDEO

SURGERY BY VIDEO

Dr Vivek Jawali
M.S., MNAMS,M. Ch. (C.T Surg.), FIACS
Chief Cardio-Thoracic & Vascular Surgeon
Wockhardt Hospitals, Bangalore



Recent developments in video camera techniques, new instruments and advanced surgical techniques have increased the importance of thoracoscopy in both the diagnosis and therapy of diseases of the chest. Many diseases previously demanding open surgery can today be treated by video-assisted thoracic surgery with the same results. The advantages are less operative trauma, less postoperative pain, better cosmetic results and shorter hospital stay.Video-assisted thoracoscopic surgery (VATS) is performed under general anaesthesia, usually with single lung ventilation. One or more small incisions in the chest allow a tiny fibre-optic camera (the thorascope) to be inserted through one incision, and surgical instruments to grasp or cut and staple, are inserted through these incisions. The thorascope transmits images of the inside of the chest on a video monitor, guiding the surgeon in manoeuvring the instruments to complete the procedure. Using video-assisted operative thoracoscopy, we can successfully operate on patients to diagnose and rectify many other problems-like conducting biopsies for diagnosing complex diseases, and excision of small tumours.The risks: There are some potentially serious risks from VATS. Air leaks from the lung that don't heal quickly can keep you in hospital longer and occasionally require additional treatment. About one percent of patients have significant bleeding, requiring a transfusion or larger operation.Sometimes, especially if cancer is diagnosed, your doctors will decide that you need a larger surgery to treat your problem in the safest manner possible. If necessary, the doctors can change over to a larger incision and do open chest surgery while you are still under anaesthesia. Death from complications of VATS does occur in rare cases, but less frequently than with open chest surgery.

The author is chief cardiothoracic & vascular surgeon, Wockhardt Hospitals, Bangalore.