Video-assisted thoracoscopy surgery

Abstract

The VATS approach has been an important milestone in thoracic surgery, allowing surgery in patients who would never have been candidates for it through an open thoracotomy approach. The lower postoperative morbidity, the decrease in the intensity of postoperative pain, the reduction in time for chest drains, and the shorter hospital stay have allowed "intensified recovery" programs to be considered and carried out in thoracic surgery.

VATS thoracic surgery has some peculiarities in which the role of the anesthetist is essential. Video-assisted thoracoscopy requires total lung collapse for adequate surgical vision. This requires the use of lung isolation devices and single-lung ventilation by anesthesia. Likewise, the protective ventilation strategy is important in both one-lung and two-lung ventilation. In addition, to facilitate a more rapid recovery of the patient, adequate control of postoperative pain is essential.

Currently, VATS is the technique of choice for most thoracic procedures.