Video Assisted Thorascopic Lung Surgery

If you have any questions or concerns about any of the issues on this page, please do not hesitate to ask any of the nurses on the ward when you are admitted. They will be happy to answer your questions.

Video Assisted Thorascopic (VATS)

This is also known as ‘Keyhole’ surgery. It is a minimally invasive surgical procedure used to access inside the chest area. This allows the surgeons to take samples of the lung, or the lining of the lung, which can then be examined under a microscope. These samples will help diagnose your lung condition so that we can decide what will be the best treatment for you.

The procedure is done under a general anaesthetic and you will need to stay in hospital about 3-4 days.

During the procedure 2-3 small cuts, about 2cms long will be made. This allows the surgeon to pass a tiny camera (thoracoscope) into the chest area to watch their progress on a screen. The surgeon then uses the other two small cuts to pass the surgical instruments into the chest area to take biopsies.

Types of procedures using VATS

Pleurectomy

A pleurectomy involves removing the lining between the lung and the chest wall. This causes the surface of the lung to stick to the rib cage, preventing further collapse. The most common reason for having a pleurectomy is that you have a collapsed lung (pneumothorax) that keeps recurring.

Bullectomy

A bullectomy is a surgical procedure to remove bullae from the lungs. Bullae are thin-walled, air-filled spaces in the lungs. The surgeons remove the bullae in the elderly to allow surrounding healthier lung tissue to expand and work more efficiently.

Decortication

This is a surgical procedure that peels a restrictive layer of scar tissue overlying the lung, chest wall, and diaphragm. The aim of decortication is to remove this layer and allow the lung to re-expand.

Pleurodesis

This is where the surgeon introduces sterile talc into the chest cavity or uses other ways to fuse the lung to the rib cage. A Pleurodesis is done to prevent recurrence of a pneumothorax (collapsed lung) or recurrent pleural effusions (collection of liquid in the chest cavity).

General Information

Ward details

J84 is on Level 2 in Bexley Wing. We are a 32 bedded ward with eight side rooms and six bays. Each bay has its own toilet and shower room. All side rooms are ensuite. Ward 84 is a mixed sex ward but all bays are single sex. During your stay in hospital you will meet a team who work together with the aim of providing the highest quality of service for all your needs.

Contacting us

Ward J84 Telephone Number – 0113 206 9184

Visiting times

Our daily visiting times are: 2pm – 8pm

Visiting times are restricted for the following reasons:

• to allow patients time to rest and recover;
• to allow nurses to carry out nursing cares;
• to prevent infection;
• to ensure patients are not disturbed during mealtimes;
• to allow the ward to be cleaned.

During visiting the number of visitors is restricted to two visitors per bed. Children under 12 years of age are not allowed. If there are special circumstances regarding visiting, please ring the ward before visiting and speak with the nurse in charge. All children must be accompanied by a responsible adult at all times.

Telephone Enquiries

We kindly ask that phone enquiries be made after 11am by a nominated family member who can then pass on information to others. Mornings are particularly busy for the nurses and large volumes of telephone enquiries means that nurses spend less time with patients. Please also be aware that nursing staff cannot give out detailed medical information over the telephone.

Infection prevention

Infection prevention is an important issue. To prevent the spread of infection we ask that all patients, visitors and staff use alcohol gel on their hands when entering or leaving the ward. Alcohol gel can be found in dispensers at the entrances and exits of the ward and also at the entrances to the bays and side rooms.

What happens on the day of your admission?

All patients having lung surgery will be admitted to either the Admission Lounge or David Beever’s Unit at 7am. Your admission letter will tell you which one. Please take any morning medication by 6am before coming into hospital. If you are on medication for diabetes or blood thinning you must not take these on the morning of your surgery.

The morning of your operation

You will need to bring with you:

• all your current medications;
• toiletries;
• dressing gown;
• two clean sets of nightwear;
• well-fitting slippers;
• loose fitting comfortable clothes;
• a small amount of loose change for newspaper etc;
• a pen.

Please do not bring valuables or large amounts of money into hospital.

The nurses will get you ready for surgery. This will include:

• checking your blood pressure, temperature and pulse;
• being seen by a surgeon;
• reviewed by the anaesthetist and;
• being asked to wear surgical stockings

You will be seen by an anaesthetist on the morning of the operation who will ask you questions about your health and about any problems you may have had with previous anaesthetics (e.g. sickness). You will also be seen by the surgeon.

You will have to fast (have nothing to eat) from midnight but you are allowed to have clear fluids up until 6am.

You must remove contact lenses but you can wear your glasses, hearing aid, dentures or wig to the anaesthetic room. You will need to tie back long hair but should not use metal clips.

Recovery after having had an anaesthetic

Oxygen

You will wake up from your operation with an oxygen mask that fits over your mouth and nose. This ensures that you receive sufficient oxygen to help you recover from the anaesthetic. Your nurse will inform you how long you need to use the oxygen for.

Pain Control

The nurse looking after you will assess to see if you are in any pain regularly. Please remember, the most effective way of managing your pain is for you to tell the nurse that you have pain! It is important to tell your nurse if the painkillers are not working so that they can give you an alternative.

Nausea & Vomiting

Some patients experience nausea and vomiting after surgery because of the anaesthetic. Please inform the nursing staff if you experience nausea or vomiting so they can give you medication to stop this.

Eating & Drinking

When you are fully awake you will only be able to have sips of water. Once you have managed with the water without upsetting your stomach you will be able to have a cup of tea, usually about one hour after you return to the ward. If you manage the cup of tea without upsetting your stomach you may then eat as normal.

Drains

Following a VATS biopsy you will have a flexible plastic tube in your chest to remove air, fluid or blood. Once the surgeons are happy that there is no air leak the drain will be removed. This usually happens 2-3 days after surgery.

While you have the drains in you must NOT:

• lift the drain above your waist;
• disconnect the drain tubing;
• knock your drain over (pick it up and inform the nurse immediately if accidentally knocked over);
• kink or obstruct the chest drain tubing.

When the drain has been removed you will have a stitch that will need to be removed 7-10 days after the drain has been removed. You can arrange for this to be removed by your practice nurse at your GP surgery. If you are not able to get to your GP ask the nursing staff to arrange for a district nurse to come to your house to remove it.

Planning for going home

How long you stay in hospital will depend on what type of surgery you have had.

Once the doctors and nurses have decided that you are ready to go home we will organise the following:

• medication that you will need to take home;
• a follow up outpatient appointment;
• a nurse led clinic appointment if needed;
• transport home if appropriate.

Medication

If you need any medication such as painkillers we will give you a supply to take home. Within 24 hours of going home a letter will be sent to your GP with a list of the medication that you have been discharged with. It will also contain information about your surgery and hospital stay. You also be given a copy of your discharge letter with a list of your medication.

Constipation

Constipation can become a problem due to painkillers and the anaesthetic. Going for regular walks, drinking plenty of fluids and making sure you have plenty of fibre in your diet will help prevent this.

Wound Care

Check your wounds every day in a mirror if you can or ask someone to look at it for you. If your wound is clean and dry there is no need for a dressing. Some swelling around the wound is perfectly normal and should go down after a few weeks.

If you notice any of the following you must seek medical advice from either Ward J84 or your GP:

• the amount of pain in your wound increases;
• the wound becomes redder than before;
• the wound becomes warm to the touch;
• the wound becomes swollen;
• the wound has a discharge coming from it;
• any part of the wound appears to be coming apart.

Post Discharge

Outpatient Appointment – You will receive a clinic appointment to see the surgeon about four weeks after surgery.

Air travel – Please check with your surgeon before flying. We would advise that you do not fly for around six weeks after keyhole surgery. You should also check with your travel insurer to make sure that you are covered to travel.

Returning to work – This will depend on how you are feeling and the type of job that you do. If it is light work then you may be able to go back to work after about two weeks. If it is heavy manual work then it may be longer. You can discuss this with your surgeon before you go home.

Driving – To be able to start driving again you must be able to make an emergency stop without causing yourself too much discomfort. You must also be comfortable enough to twist to be able to reverse your car.