A team of doctors at Fortis Hospital, Mohali introduced a new technique – Video Assisted Thoracoscopic Surgery(VATS) – to successfully treat a 70-year-old man from lung cancer here recently. This 'minimally invasive surgery' is a unique and first of its kind procedure to be performed in this part of the country. The team was led by Dr. Vijay Jagdish Jagad, Consultant, Surgical Oncology, Fortis Hospital, Mohali.
Procedure: A tiny camera (thoracoscope) and surgical instruments are inserted into the patient's chest through small incisions of 5-6 cms. The tumour can then be excised through videos transmitted onto a video monitor guiding the surgeon in performing the procedure.
Case History: The patient was diagnosed with neuroendocrine tumor of lung. He was advised a Dotanoc Pet Scan which revealed lesion confined to the left lung. If it was left undiagnosed and untreated, it would have spread to his brain, liver and bones and harmed him immensely. Patient was advised to undergo VATS Left upper lobectomy. The surgery went on successfully and everything went on smooth. Patient was discharged on 5th post-operative day.
Advantages over Conventional procedure: The new VATS technique has multiple advantages over open procedure. It is minimally invasive which means it is less painful, minimal loss of blood and swifter recovery. The technique also shows minimal effect on patient’s immune status which is a definite improvement over open surgery. The chances of post-operative infectious complications are lesser. VATS causes least damage to the ribs and intercostal nerves and hence post-operative lung function is maintained and it is beneficial for those who need post-operative chemotherapy or radiotherapy.Surgical procedures done by conventional open procedure requires 15 to 20 cms incision over the chest and is fraught with high death rates owing to post-operative major complications.
Uses: VATS can be performed for various lung pathologies like Lobectomy (surgical removal of a lobe of an organ) and Pneumonectomy (surgical removal of a lung or part of a lung) for lung cancer, Drainage of Empyema Thoracis (condition where thick-walled pus-filled cavity is present within the pleural cavity), Lung reduction surgery for patients of chronic obstructive pulmonary disease, Bullectomy (Patient who develop large air-filled lung space due to chronic lung disease) etc. VATS technology causes minimal trauma and speedy recovery hence reduces the overall morbidity of the procedure,” added Dr Jagad.
Lung cancer remains the most common cause of cancer related death among men. The global incidence of lung cancer is increasing. Lung cancer is commonly diagnosed at an advanced stage where the patient presents with cough with expectoration (discharge matter from throat/lungs by coughing or hawking and spitting) or shortness of breath. Sometimes, the patient presents in a very advanced stage of the disease, where it has spread to the bones and brain. Screening is the most effective method to detect lung cancer at early stage, where a battery of certain tests can be carried out in healthy high-risk individuals. Screening for lung cancer can be performed by low dose CT scan of chest. If screened positive, treatment of lung cancer revolves around trimodality therapy i.e., Surgery, Chemotherapy and Radiotherapy.
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