Chapter 11 - Anesthesia for video-assisted thoracoscopic surgery

Summary

Video-assisted thoracoscopic surgery (VATS) has become a vital part of the armamentarium of the surgeon. VATS is associated with shorter length of hospital stay and less use of pain medication than thoracotomy in the treatment of pneumothorax and minor resections. General anesthesia is usually induced with an intravenous agent such as propofol or thiopentone and maintained with an inhalational agent such as isoflurane in an air/oxygen mixture. The isolation and division of the bronchi and pulmonary blood vessels require more accurate and extensive dissection with VATS than conventional surgery. Thoracoscopic lobectomy can be oncologically equal to conventional open procedures with an experienced surgeon and have similar survival for early stage non-small cell lung cancer. Conversion to a thoracotomy is sometimes required if there is an unexpected change in the patient's condition such as chest wall invasion or the need for a sleeve resection.