Open surgery (Sternotomy or Thoracotomy) involves an incision into the pleural space of the chest by division of one or more major muscles of the chest wall along with spreading of the ribs. Today, open surgery has been used for advanced stage of lung cancer or when minimally invasive lung resection is impossible or risky to perform.
Traditionally, open surgery provides highly effective means of access to lungs or other thoracic structures. However, it is a more difficult operation for patients to tolerate as it has the potential for causing significant pain that may last for significant period of time. The procedure results in bony fractures that require a minimum of six weeks to heal during which time patients must not do heavy lifting or involve in physical activities.
To avoid division of muscle and bone fractures the thoracic surgeons invented a minimally invasive lung resection technique, so called Video Assisted Thoracoscopic Surgery (VATS). It is a fairly recent technique, which is usually employed for early stage lung cancer as well as benign lung conditions. It involves an introduction of a small video camera into the patient's chest via a scope. The camera and instruments are inserted through separate holes in the chest wall.
Compared with open surgery, the minimally invasive lung resection has fewer complications. The small holes made during VATS significantly reduce the chance for infection. VATS allow for a faster recovery by the patient and provide a greater chance for the wound to heal. This results in reduction of length of hospital stay and improvement in patient’s quality of life.
Although VATS have clear advantages to open surgery, VATS is difficult to master. To be performed effectively, it requires dedicated and focused training, and experience with a relatively large volume of cases.
Mr Sergei Mitnovetski is a dedicated cardiothoracic surgeon who spent many years of his intensive thoracic training in mastering minimally invasive techniques and has a substantive experience in VATS procedures.