What Is VATS (Video-Assisted Thoracoscopic Surgery)?

Medically Reviewed by Sabrina Felson, MD on September 15, 2021

VATS (video-assisted thoracoscopic surgery) uses smaller surgical cuts than traditional lung surgery. That makes it a less invasive procedure with a quicker recovery.

Your doctor might recommend VATS to gain access to your chest cavity (aka the thorax), especially the heart and lungs. They may do this to check the area for problems such as tumors, to take a sample of tissue, or to do surgery.

If you get VATS, your surgeon makes one to five small cuts between your ribs and passes a small video camera and light through one opening and special instruments through the other ones. This allows the surgeon to see more clearly and operate.

VATS for Biopsy

When you get a biopsy, your surgeon removes a small piece of tissue to check it under a microscope for cancer cells. Doctors use VATS to biopsy:


Your surgeon might use VATS to remove part of a lung (or all of it) because of infection, sudden injury (trauma), or cancer. Other surgeries include:

  • Removal of all or part of the esophagus
  • Removal of all or part of the thymus gland
  • Pacemaker placement
  • Repair of the heart’s mitral valve
  • Surgery on heart for an irregular heartbeat
  • Drainage of fluid from lung or abscess
  • Drainage of fluid around the heart
  • Removal of fibrous tissue around the lung
  • Surgery to stop fluid buildup around the lung
  • Repair of problems in diaphragm or chest wall

Preparing for VATS

Leading up to your surgery, your doctor will check your overall health and see how well your lungs are working. You may get:

  • Images of your chest from X-rays, CT scans, or PET scans
  • An EKG (electrocardiogram) to check your heart's health
  • Lung tests
  • Blood tests

You also might need to do some things to get ready for VATS. Your doctor will tell you exactly what you need to do. Depending on the doctor and the procedure, you may need to:

What Happens During VATS

Each procedure and doctor is different, but there are some common elements.

VATS will last a couple of hours or more. You’ll get general anesthesia so you’re not awake during the procedure. Your surgeon will make a few cuts in your chest cavity and insert the camera (called a thoracoscope), light, and instruments. The placement and number of cuts might vary according to the type of surgery. After the surgery, your surgeon will close up the cuts. Medical professionals will dress and bandage the wounds.

After VATS

When you wake up after the procedure, you’ll likely have a tube that drains liquid from your chest. It probably will be a few days before you can go home. Medical staff will watch your breathing, heart rate, blood pressure, and other signs of health.

You’ll likely get antibiotics to help prevent infection from the surgery. A breathing therapist might help you take deep breaths a few times a day. This may also help prevent infection.

Though VATS is not as hard on you as traditional lung surgery, it still takes a toll on your body, especially if you’re older. It will likely take a few weeks to get your full strength and energy back. It’s best to take it easy and not do any heavy lifting so your surgical wounds can heal. You may still need to take antibiotics during this time, and you’ll have follow-up appointments so your doctor can check your progress and look for infections.

Show Sources


American Lung Association: “Minimally Invasive Thoracic Surgery.”

Cleveland Clinic: “Video-Assisted Thoracic Surgery (VATS).”

Johns Hopkins Medicine: “Video-Assisted Thorascopic Surgery.”

Mayo Clinic: “Video-assisted thoracoscopic surgery (VATS).”

Rush University Medical Center: “Video-Assisted Thoracoscopic Surgery (VATS).”

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