What types of operations can be done with VAT?
Minimally invasive thoracic surgery can be achieved with video-assisted thoracoscopy (VAT). Typically, three to five small incisions (portals) are created to allow entry of instruments, including the camera, which is connected to a monitor, into the thoracic cavity.
VAT can be used for biopsy of intrathoracic structures, such as lung masses, pleura, and mediastinal masses. If the biopsy of the lung nodule is positive for cancer, the surgeon can then proceed with an open thoracotomy for a more extensive resection, such as a pneumonectomy. A lung lobectomy can also be performed via VAT. Other lung surgery that can be performed with VAT includes resection of bullae, treatment of pneumothorax or empyema, and diagnosis and treatment of thoracic trauma.
Esophageal surgery can be performed with VAT. This includes esophagomyotomy for achalasia, although this can be performed from the abdominal approach with laparoscopy and thoracoscopy. Traditionally, the Ivor Lewis esophagectomy was accomplished through the use of laparotomy and right thoracotomy incisions.
Pericardial surgery can be done with VAT. This includes pericardiectomy as treatment for pericardial effusion. Excision of a pericardial cyst and “takedown” of the inter-nal mammary artery for coronary artery bypass grafting can also be accomplished with VAT.