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.
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