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Overview of video-assisted thoracoscopic surgery (VATS)

Todd Demmy, MD
Elisabeth Dexter, MD
Section Editor
Joseph S Friedberg, MD
Deputy Editor
Kathryn A Collins, MD, PhD, FACS


Video-assisted thoracoscopic surgery (VATS) is a set of minimally invasive thoracic surgical procedures utilized to diagnose and/or treat intrathoracic diseases and reconstruct chest wall deformities. This topic will review: the role of VATS as a diagnostic and therapeutic tool, the preoperative assessment, instrumentation, and intraoperative challenges.

Conditions that can be treated using a VATS approach are discussed in specific topic reviews. (See "Surgical evaluation of mediastinal lymphadenopathy" and "Surgical resection of pulmonary metastases: Benefits, indications, preoperative evaluation and techniques" and "Surgical management of resectable esophageal and esophagogastric junction cancers".)


VATS and thoracoscopy are frequently used interchangeable terms that describe a minimally invasive surgical (MIS) approach to the thorax. However, there are notable differences in the approaches:

VATS uses an access or utility incision that ranges from 4 to 8 cm in length and allows manipulation of multiple traditional thoracotomy or thoracoscopic instruments through a single incision at the same time, though with the possibility of using additional 0.3 to 1.5 cm incisions. The term “uniportal” refers to the use of VATS through only one utility incision and is becoming more popular [1].


VATS is used as a diagnostic and therapeutic tool as well as a reconstructive intervention for benign and malignant intrathoracic diseases. Many procedures historically performed as an open thoracotomy are now performed as VATS. Examples of diagnostic, therapeutic, and reconstructive procedures that can be performed by a VATS approach include:


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Literature review current through: Sep 2016. | This topic last updated: Aug 24, 2015.
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