Northwestern Memorial Hospital Patient Education
ABOUT YOUR SURGERY
Video-Assisted Thoracoscopic Surgery
This pamphlet will give you helpful information to guide you through video-assisted
thoracoscopic surgery (VATS). It describes the surgery and the care before, during and after
your hospital stay. This information will answer many of your questions.
In VATS, the surgeon uses a “minimally invasive” method. With
this procedure, your surgeon can view and operate inside your
chest using a tiny video camera and several small incisions. Using
this method, the surgeon may do many types of operations,
including:
If you have ■ Removing a portion of the lung
■ Taking a biopsy of a tumor
any questions
■ Draining fluid from around the lung
or concerns, ■ Treating recurring pneumothorax (collapsed lung)
please ask your Compared to an open surgery where your surgeon makes one
large cut in your chest, patients who have the VATS procedure
care team. often have:
■ A faster recovery
■ Shorter hospital stay
■ Less pain and less need for pain medications
Before surgery
Pre-op Clinic
We will help you schedule an appointment with the Northwestern Memorial Hospital Pre-
operative (Pre-op) Clinic. You will have an evaluation by the care team to make sure you are
ready for surgery. You will meet the anesthesia team at this time.
Surgery time
Surgery time schedules are subject to change. The day before your surgery (or on Friday if
your surgery is on Monday) a staff member from the surgeon’s office will call you between
4 and 5 pm to discuss your arrival time, place and the estimated time of your surgery.
If you do not get a call by 5 pm, missed the call or would like to talk with the pre-op nurse,
please call the Northwestern Memorial Hospital Same-Day Surgery Desk at 312.926.5450
before 7 pm.
Night before surgery
Please follow the instructions you get from the Pre-op Clinic about your medications and
diet. Do not eat anything after midnight the night before surgery. You may have water,
black coffee or other clear liquids up to 2 hours before your scheduled arrival time. You
may take medications with a small sip of water, if directed to do so by the Pre-op Clinic
care team.
Day of surgery
At home
Shower, wash your hair and brush your teeth. Do not wear eye makeup or contact
lenses. Wear loose-fitting clothing.
Please do not bring valuables, such as money or jewelry, to the hospital. Bring these
items with you:
■ Your photo ID
■ Method of payment for discharge medications
■ Medical insurance information
■ Copies of your advance directive, living will or power of attorney (if you have
completed these forms)
■ Continuous positive airway pressure (CPAP) device if you have sleep apnea
■ Any assistive devices or equipment you will need after surgery
Hospital arrival
Please arrive for check-in at the Same-Day Surgery Reception Desk on the 5th Floor of
Galter Pavilion. If you were not given a specific arrival time, please arrive 2 hours before
the time of your surgery.
The staff will take you to the pre-op area. Visitors who plan to stay and wait should
check in with the volunteer staff in the Surgical Waiting Room on the 5th or 7th floor
in Feinberg Pavilion. Family members should check in with the volunteer who will give
them updates on your progress during surgery.
You must have a responsible adult available to take you home after surgery. For your
safety, you cannot leave the hospital alone.
Preparation for surgery
Once you are in the pre-op area, you will change into a hospital gown. The nurse will
review your medical history and take your temperature, blood pressure and pulse.
Tell the nurse the exact time you last had anything to eat or drink. The nurse will put
an IV (into the vein) line into your hand or arm. The care team will use it to give you
medications to help you relax and fluids. A member of the anesthesiology team will talk
with you about the anesthesia plan. A member of the surgical team will meet with you
and answer any questions.
We make every effort to start surgery at your scheduled time but delays may happen.
We will keep you and your family updated about any delays.
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During surgery
Once you arrive in the operating room (OR), you will get general anesthesia. It starts
with IV medication and includes breathing anesthetic gases mixed with oxygen. You will
not be aware of the surgery or your surroundings.
The care team will position you comfortably on your side. The surgeon will make a very
small incision, usually between your 7th and 8th rib. They will insert a tiny camera on a
tube, known as a thoracoscope, through the opening. They will make 1 or 2 other small
incisions to do the surgery (Figure 1).
Figure 1. Positioning during VATS
At the end of your surgery, the surgeon will close all but 1 of the small incisions. They
will put a chest tube in this incision and connect it to a container. The tube will drain air
and fluid from your chest.
After surgery
Pain
Most patients will have pain that increases when they take deep breaths, cough or
move. Our goal is for you to be able to walk, cough and deep breathe comfortably. Your
physician will prescribe medications to help manage the pain. Take the pain medication
as often, as directed. Hold a pillow firmly over your incisions (splinting) when you have
to cough to help manage the pain.
Diet
You will start eating a clear liquid diet and then progress to your regular diet as you
are able. If you get an upset stomach, please tell the nurse. It is important to prevent
constipation, especially while taking pain medications. Please take your stool softeners
as directed.
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Activity
Most patients are out of bed with help on the day of surgery and walking in the hallways
the next day. It is important to walk in the hall 4 to 5 times each day. Please continue to
take short, frequent walks once you return home. Walking helps prevent blood clots.
Follow these instructions for 4 to 6 weeks, unless otherwise directed by your surgeon:
■ Do not lift more than 10 pounds (the weight of a gallon of milk).
■ Do not submerge the incision under water (showering is OK after 48 hours).
■ Do not travel by airplane.
■ Do not drive if you are taking pain medications.
You can resume sexual activity If you can walk up a flight of stairs without becoming
short of breath.
Incision care
You will have a bandage over the chest tube incision site. Keep it on for 48 hours.
Then, after you take the bandage off, you may shower. Do not use lotions, creams or
powders near the incisions until they are completely healed. Some bruising or redness is
common. Itching or a small amount of drainage is also normal. Tell your care team if you
notice any sign of infection, such as increased redness, swelling, pain or drainage from
the incision.
Deep breathing
To be sure you are taking deep breaths, you will use a device called an incentive
spirometer (Figure 2). You should take 10 deep breaths with the spirometer every hour
you are awake. This is important to prevent pneumonia.
Figure 2. Incentive spirometer
Indicator
Disc
Mouthpiece
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Incentive spirometer use
1. Close your lips tightly around the mouthpiece.
2. Breath in slowly and deeply through your mouth. The indicator is on the right.
Keep the indicator between the 2 arrows.
3. Hold your breath for 3 to 6 seconds to keep the disc at the highest level you can.
4. Release the mouthpiece and breathe out slowly.
5. Repeat 10 times every hour while awake. Try to reach the same level with each
breath.
6. After 10 breaths, cough to clear mucus from your throat and chest.
7. Once you can keep the disc at that level most of the time, try a higher level.
Follow-up
If you do not already have an appointment, call your physician’s office to schedule a
follow-up visit within 2 weeks after your surgery.
When to call the physician
Call the Thoracic Surgery Clinic at 312.695.3800 if you have these symptoms:
■ A temperature more than 100.4 degrees F
■ Increased swelling, redness, or tenderness at the incision site
■ Drainage from your incision
■ Shortness of breath
■ Severe pain not managed by pain medication
In case of emergency, call 911 or go to the nearest Emergency Department.
Please call if you have any questions or concerns.
More information
Hotel information
If your loved ones would like hotel discount information, please call 312.926.7666.
Financial questions
If you have questions about financial assistance issues, please call the Northwestern
Memorial HealthCare Financial Counseling team at 800.423.0523.
Return to work
Most patients return to work within 4 to 6 weeks. Please give any necessary paperwork,
such Family and Medical Leave Act (FMLA) forms, to the outpatient team either before
or after your surgery. Please allow 5 to 7 business days for the team to complete this
paperwork. If you need a return-to-work letter, please contact the Thoracic Surgery Clinic.
For more information about Northwestern Medicine, please visit our website at nm.org.
Developed by: Northwestern Medicine Canning Thoracic Institute
© March 2023 Northwestern Memorial HealthCare
900810 (3/23) Video-Assisted Thoracoscopic Surgery
