Mangaluru: Mangala Hospital and Mangala Kidney Foundation proudly announced the installation of Thoracoscopy equipment for surgeries in the chest and lungs. Keeping up our tradition of being leaders in introducing the latest surgical methods at affordable costs, the equipment is being installed for the first time in the District.
This is the era of technological advances. The field of surgery has been revolutionized by the birth of Minimal Access Surgery, also known to the world as Keyhole surgery. This involves performing surgeries, within the human body, by introducing instruments and a telescope (camera) into the body via small incisions. Over the last few years all specialties have adopted keyhole surgery in their respective fields for the benefit of the patient. Few examples are: Laparoscopy (keyhole surgery of abdomen) and arthroscopy (keyhole surgery of joints). Similarly, the field of thoracic surgery has seen the emergence of Thoracoscopy.
The first thoracoscopy was performed way back in the year 1918 by Dr. Hans Christian Jacobson for the treatment of tuberculosis. Today it is being used world over for performing all kinds of surgeries in the chest and lungs.
What is VATS/Thoracoscopy?
Video-assisted thoracoscopic surgery (VATS) is a surgical procedure used to treat diseases of the chest and lungs. It is a type of ‘keyhole’ surgery where only very small cuts (incisions) are made on the chest to introduce instruments. VATS uses a special instrument called a Thoracoscope. This is a thin, tube-like instrument (telescope) which has a camera attached to the outer end. The camera feeds pictures from the chest on to a video monitor. This allows the surgeon to look inside the chest without making large incisions. VATS can be used to do a wide range of surgeries, including take small samples of tissues (biopsy) from the lungs or pleura. These samples can then be examined in the laboratory.
What are the uses of VATS?
VATS is used for many different procedures like, Diagnostic (to diagnose disease) Lung biopsy, Pleural Biopsy, Biopsy of mediastinal masses, Staging of lymph nodes in cancer Excision of indeterminate lung nodules, Therapeutic (to treat a disease), Obliteration of pleural space (Pleurodesis) for malignant disease Excision of benign pleural lesions, Excision of benign lung tumors, Sympathectomy for hyperhidrosis and upper-extremity pain syndromes, Stapling of lung blebs (air pockets in the lungs causing a serious condition called pneumothorax) Drainage of Empyema ( pus around the lungs) or lung abscess ( pus in the lungs)
Other Indications for VATS
Excision of mediastinal tumors (thymoma, posterior mediastinal tumors) Pericardial biopsy or fenestration.
Excision of lung cancer
– Volume reduction for bullous lung disease
– Video-assisted lobectomy
Esophageal myotomy for achahasia Excision of esophageal leiomyoma Ligation of thoracic duct for chylothorax
– Staging lymph nodes in esophageal cancer
– Treatment of thoracic spine disease
How is this surgery performed?
Patients are placed under general anesthesia and are positioned on their sides. Using a trocar, the surgeon gains access into the chest cavity through a space between the ribs. The thoracoscope is the inserted through the trocar, giving the surgeon a magnified view of the patient’s internal organs on a television monitor. The surgeon makes two or three small(1-2 em) incisions in the chest wall. Then he/she inserts special surgical instruments into the other incisions as per requirement. These instruments can be used to remove tissue which may have been seen on an X-ray or CT scan, or fluid found in the chest. Once the surgery has finished, the instruments are removed and the incisions are closed, usually with stitches.
It is usually easier for patients to recover from VATS compared with normal chest surgery (often called ‘open’ surgery) because the wounds from the cuts (incisions) are much smaller.
Advantages of ‘Thoracoscopic surgery’ over ‘Open surgery’
Smaller incisions, Less postoperative pain, Early discharge from hospital Quicker return to work along Better cosmesis.