Advanced Minimally Invasive Thoracic Surgery
Video Assisted Thoracoscopic Surgery (VATS) / Robotic Assisted Thoracic Surgery (RATS)
Thoracoscopic surgery (VATS) is a surgical method, through which inside of rib cage is visualized with a camera and surgeries can be carried out with minimal tissue damage at surgical entry points. Thanks to its advantages over open surgery method, the technique is commonly preferred in the field of thoracic surgery and stands out to be the most frequently utilized surgical method at our clinic.
Thoracoscopic surgery can be broadly explained as a practice of the surgical method that is colloquially called “closed / camera assisted surgery”, utilized in the chest cavity. Within scope of VATS procedure, one or several small incisions are made on the chest wall. A camera called thoracoscope and proper surgical tools for the technique are inserted into the thorax through the incisions. Every corner of the chest cavity can be visualized with the camera and projected on a screen; the surgeon performs the surgery by tracking the images on the screen. The incisions are much smaller compared to those made in open surgery. Damage on muscles supporting respiration is minimized and surgery is performed without stretching ribs. Thanks to the mentioned advantages, VATS is much less painful and much more comfortable surgery compared to open surgery method. The above mentioned benefits shorten duration of hospitalization and patients can return to their normal daily lives in the shortest time possible.
VATS can be used for both diagnostic and therapeutic purposes in thoracic surgery. VATS can be safely used in pleural diseases, diseases of mediastinum, which is located between both lungs and in diseases of actual lung tissue, such as lung cancer. Most of the surgeries that can be performed with open method can be perfectly performed with VATS technique.
Robotic assisted surgery system consists of a console operated by the surgeon, a robotic unit with 4 interactive robotic arms operated from the console and a screen. Surgery is performed after various devices necessary for the procedure are installed on the robotic arms.
Robotic assisted surgery has gradually become more popular in the last five years, since it was released to the market. They are produced to be technologically superior to conventional endoscopic methods used in thoracoscopic surgeries. The method provides the surgeon with the closest experience to a wrist, by means of freedom of motion (up-down, forward-backwards, right-left, flexion-extension, abduction-adduction, pronation-supination, grasping) by 7 degrees, the highest degree in robotic arm technology that cannot be achieved with thoracoscopic devices. Moreover, it does not reflect tremors of the surgeon’s hand. Also, 3-dimensional image projection of robotic assisted systems enables better depth perception for the surgeon.
All surgeries that can be performed with closed (thoracoscopic) method in the field of Thoracic Surgery can be performed with Robotic Assisted Surgery System. Ever since the first thoracic surgery with robotic system was performed in our country by our team on a patient with lung cancer in 2010, we have been using the method successfully mainly for surgeries of lung and esophageal cancer as well as thymoma and thymus surgeries.
Surgeries performed with VATS and RATS;
- Lung biopsies, surgical excision of nodules from lungs (wedge resection)
- Lung cancer surgeries / lung resections (e.g. lobectomy, segmentectomy)
- Lymph node biopsies
- Biopsy/excision of mass lesions in mediastinum (middle chest cavity between lungs)
- Surgeries of thymus gland or thymoma (mass lesions of thymus gland)
- Surgeries of excessive sweating (hyperhidrosis) of hand
- Pneumothorax (air leak from lungs) surgery
- Bulla / bullous lung surgeries
- Biopsies and surgeries of pulmonary membrane (pleura)
- Surgeries for fluid accumulation in rib cage (pleural effusion) (drainage / pleurodesis)
- Surgeries for effusions in heart membrane (pericardium) (pericardial window)
- Diaphragm surgery (plication/defect repair)
In conclusion, minimally invasive thoracic surgery (VATS or RATS) is efficiently and safely performed by experienced surgeons in modern practice of thoracic surgery. Since numerous surgeries can be perfectly carried out with this technique and it provides many advantages; it stands out as a surgical method that is mostly preferred over open surgery.
We prefer VATS or RATS surgeries at our clinic over open surgery methods since they were first started to be used in our country. Minimally invasive surgeries correspond to more than 85% of all surgeries carried out at our clinic. Our team that has been working together for more than twenty years, attends domestic congresses and courses as instructors, due to their experience and accumulated knowledge in the field of thoracoscopy.