What is Uniportal VATS? A Complete Patient Guide — Written by a VATS Surgeon

Every week in my clinic at KG Hospital, Coimbatore, I meet patients who have been told they need lung surgery. The first question is almost always: "Doctor, will I need to have my chest opened?"

For the vast majority of my patients with early-stage lung cancer, the answer today is no. Instead, I perform Uniportal VATS — where the entire operation is done through a single incision of just 3–4 cm. No rib spreading. No large wound. Home in 2–3 days.

What Exactly is VATS?

VATS stands for Video-Assisted Thoracoscopic Surgery — keyhole surgery of the chest. A tiny high-definition camera (thoracoscope) is passed into the chest cavity through a small incision, allowing the surgeon to see and operate inside the chest without opening it.

Uniportal VATS is the most advanced form — everything goes through a single 3–4 cm opening. Compare this to standard (multi-port) VATS which uses 3–4 separate incisions, or open thoracotomy which requires a 15–25 cm incision and spreading of the ribs.

What Operations Can Be Done with Uniportal VATS?

• Lobectomy — removal of an entire lobe of the lung (the most common operation for lung cancer)
• Segmentectomy — removal of just one segment of the lung, preserving more function
• Wedge resection — removal of a small wedge of lung for small peripheral tumours
• Thymectomy — removal of the thymus gland for thymoma or myasthenia gravis
• Pleural procedures — drainage of effusions, biopsy of the lining of the lung
• Mediastinal tumour removal

What Happens During Uniportal VATS Surgery?

You will be under general anaesthesia — fully asleep throughout. One lung is temporarily deflated while we operate on the other side. Through the 3–4 cm incision, I pass a high-definition camera and all necessary instruments — including a stapler to divide the lung.

The removed lobe or tumour is placed in a bag and removed through the same incision. A small drain is placed at the end of the operation — this exits through the same incision — and the wound is closed with just a few stitches.

The entire operation typically takes 1.5–2.5 hours depending on complexity.

What to Expect After VATS Surgery

In Hospital (Day 1–3)

• Day of surgery: You will wake up in recovery, then move to the ward. Pain is managed with IV medication. Breathing exercises begin immediately.
• Day 1: The physiotherapist will get you sitting up and walking a few steps. The chest drain is checked — if drainage is minimal it may be removed.
• Day 2: Most patients can walk to the bathroom independently. If the chest drain has been removed and a chest X-ray confirms the lung is fully expanded, discharge is planned.
• Day 2–3: Most patients go home.

At Home (Week 1–6)

• Continue breathing exercises 10 times every hour when awake
• Short walks 2–3 times daily, increasing distance each day
• Soft diet for the first few days at home
• Return to desk work in 2–3 weeks
• Return to manual work in 4–6 weeks
• No driving until off strong pain medication and able to do an emergency stop

Is Uniportal VATS Safe? What Are the Risks?

No surgery is without risk — but Uniportal VATS is extremely safe in experienced hands. The most common minor complications include:

• Prolonged air leak: Air continues to leak from the cut edge of the lung — usually settles within a few days with the chest drain in place
• Chest infection: Prevented by early walking and breathing exercises
• Atrial fibrillation: An irregular heart rhythm that can occur after lung surgery — treatable with medication

Serious complications such as major bleeding, lung failure, or conversion to open surgery are uncommon (<5% in experienced centres) and can be managed safely in hospital.

Who is Eligible for Uniportal VATS?

Most patients with early-stage lung cancer (Stage I and II) are candidates. I assess each patient with a CT scan, PET-CT scan, pulmonary function tests, and clinical examination before recommending the best approach. Patients who are not suitable for VATS may still be candidates for robotic surgery (RATS) — which offers similar benefits through multiple small ports.

My Message to Patients Facing Lung Surgery

If you have been told you need lung surgery, please ask your surgeon whether a minimally invasive approach is possible. You do not need to accept a large chest wound as inevitable. In the right hands, Uniportal VATS gives you the same chance of cure — with a faster, less painful recovery.

I am happy to see patients for a second opinion or initial consultation at KG Hospital, Coimbatore.