Single Incision Videoassisted Thoracoscopic Surgery

Single incision video-assisted thoracoscopic surgery, commonly referred to as SIVATS, is a minimally invasive surgical technique used to diagnose and treat problems in the chest. This innovative surgery is, in many cases, an enhanced alternative not only to traditional open surgery (thoracotomy), but to multiple incision VATS. SIVATS can be used for lung, diaphragmatic and pleural biopsies, as well as for lung resections and anti-reflux procedures, making use of an incision that is only slightly longer than one inch.

While SIVATS is not appropriate in all cases, where it can be used it offers significant advantages over other types of thoracic surgery. These include:

• Shorter hospital stays
• Less pain and discomfort
• Lower cost
• Shorter recovery time

Patients who undergo SIVATS also experience considerably less scarring since only one incision is made.

During the SIVATS procedure, surgery takes place through only small incision in the chest. A tiny fiber-optic camera, called a thoracoscope, as well as miniature surgical instruments, are inserted through this single opening. The thoracoscope takes and transmits images of the surgical site to a video monitor, guiding the surgeon to manipulate the instruments precisely during the operation.

While a SIVATS procedure presents a lower risk of complications than traditional surgery, or even than some other laparoscopic procedures, there are risks inherent in any operation. Risks of SIVATS include:

• Pneumothorax (collapsed lung)
• Excessive bleeding
• Blood clots
• Postsurgical infection
• Adverse reaction to anesthetic or anesthesia

With any surgery, particularly surgery involving the lungs, there is some danger that the patient will develop breathing difficulties.

The minimally invasive approach of SIVATS results in less surgical trauma and less scarring. Patients able to undergo this thoracoscopic procedure are normally fast-tracked through the recovery process. Some patients are able to undergo certain SIVATS operations under mild sedation combined with regional epidural anesthesia, eliminating the greater risk of general anesthesia and making the procedure possibly ambulatory.