Lung surgery: How invasive is it?

Lung surgery can sound daunting, but advances in surgical technology mean that many procedures are now far less invasive than in the past. For suitable patients, techniques such as video-assisted thoracoscopic surgery (VATS) and robotic-assisted surgery allow lung conditions to be treated effectively with smaller incisions, less pain and quicker recovery times compared with traditional open surgery.

Why is lung surgery performed?

Lung surgery may be required for a range of conditions, including:

Lung cancer
Benign lung tumours or growths
Infections or abscesses
Collapsed lung (pneumothorax)
Removal of damaged tissue after injury or disease

The aim is to treat the underlying problem while preserving as much healthy lung tissue as possible.

Traditional vs minimally invasive lung surgery

Traditional lung surgery, known as thoracotomy, involves making a long incision between the ribs to reach the lung. While still necessary in certain complex cases, it requires spreading the ribs, which can be more painful and involve longer recovery.

Minimally invasive approaches have transformed lung surgery for many patients. These techniques avoid large incisions and reduce trauma to surrounding tissues.

Video-assisted thoracoscopic surgery (VATS)

VATS uses one to three small incisions, usually less than 5 cm each. A tiny camera (thoracoscope) is inserted into the chest, giving the surgeon a clear view of the lung on a screen. Specialised instruments are used to perform the surgery through the other incisions.

Benefits of VATS include:

Smaller scars
Less post-operative pain
Shorter hospital stay
Faster return to normal activities

VATS is commonly used for removing small tumours, treating collapsed lung and performing biopsies.

Robotic-assisted lung surgery

Robotic-assisted thoracoscopic surgery (RATS) is a more advanced form of minimally invasive lung surgery. The surgeon sits at a console and controls robotic arms equipped with high-definition cameras and precision instruments. This provides greater dexterity and a three-dimensional view of the chest, which can be particularly helpful for complex procedures or when operating in confined spaces. The robotic instruments can mimic the movement of the human hand with even more precision, allowing delicate dissections and suturing.

In addition to these benefits, RATS often leads to less post-operative pain, lower risk of complications, and a quicker return to normal activities compared to open surgery. It is increasingly used for lobectomies, segmentectomies, and removal of mediastinal tumours. While not every patient or hospital is suited for robotic surgery, it represents a significant step forward in thoracic surgery technology and patient outcomes.

How quickly can patients recover?

Recovery times vary depending on the procedure and the patient’s overall health, but minimally invasive approaches often allow patients to:

Spend fewer days in hospital
Experience less pain and require fewer pain medications
Regain mobility sooner
Return to work and normal life faster

Even with these benefits, patients still need to follow post-operative instructions carefully, attend follow-up appointments and allow time for the lung to heal fully.

When is open surgery still needed?

In some cases, such as when a tumour is very large, involves major blood vessels or has spread to certain areas, open surgery may still be the safest option. Your surgical team will always recommend the approach that offers the best balance between effectiveness and recovery.

What does this mean for patients?

Thanks to VATS and robotic-assisted techniques, many people needing lung surgery can now benefit from smaller incisions, quicker recovery and reduced discomfort, helping them get back to feeling better, faster.