Video-Assisted Lung Cancer Surgery: Small Incisions Mean Reduced Pain, Faster Recovery


One of the great joys in Borton's life is her garden. Because her Stanford surgeon, an expert in minimally invasive thoracic surgery, was able to remove her cancerous lung lesion with just three small incisions, she was back in her garden very quickly.

I liked Dr. Shrager the minute I met him, and with my experience, I'm a pretty good judge.

-Bonnie Borton, patient, Stanford Hospital & Clinics

Surgical nurse Wilberto Gutierrez, RN, holds the long wand that holds a fiberoptic scope for the video camera that enables video-assisted thoracic surgery (top). The scope allows Stanford physician Joseph Shrager to work inside the lungs and chest with sharp and detailed visibility. The smaller photo shows two sizes of video lenses.

It's like putting your eye right into the chest, right next to the things you're dissecting.

-Joseph Shrager, Chief, Thoracic Surgery and video-assisted lobectomy expert, Stanford Hospital & Clinics
  • Lung cancer is the second most common cancer in men and women. It is the leading cause of cancer-related deaths in the U.S. Cigarette smoking is the cause of most lung cancers, but approximately 10% of lung cancers occur in non-smokers.
  • Symptoms can include persistent coughing, coughing up blood, hoarseness, chest pain, wheezing, lung infection, or  weight loss. A chest X-ray or CT scan may determine the first indications of illness.
  • PET scan, endobronchial ultrasound or mediastinoscopy, or brain MRI may be needed to track the possible spread of the disease to the  lymph nodes in the chest or to distant sites in the body.
  • A lobectomy is the most common operation and involves the removal of an entire lobe of the lung. In most hospitals, it is still performed with a large incision, rib-spreading procedure called a thoracotomy. At Stanford and a few other medical centers, surgeons have the option of VATS, video-assisted thoracic surgery, which is completed with three small incisions and without spreading the ribs.
  • A pneumonectomy removes an entire lung and is considered the most drastic approach. Some patients do well with this, but it can mean long-term disability because of shortness of breath.
  • A sleeve lobectomy is used when cancer is found at the origin of the airway to a lobe. It is the most complex type of surgery but may avoid the more injurious pneumonectomy.
  • A segmentectomy means just a portion of a lobe is removed and can be appropriate for some smaller tumors.

I was walking around the kitchen and I was giving each one of them a hug and they were looking at me like, 'God, this woman just had major surgery!'

-Bonnie Borton, patient, Stanford Hospital & Clinics
Video Transcript