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