Name: Uniportal VATS Lung Surgery
Creator: Dr. Prabhakaran U

Understanding the Procedure

What is Uniportal VATS?

VATS (Video-Assisted Thoracoscopic Surgery) is keyhole surgery of the chest. Uniportal VATS is the most advanced form — the entire operation is performed through a single incision of just 3–4 cm. A tiny camera (thoracoscope) and all surgical instruments enter through this one opening.

Traditional open chest surgery (thoracotomy) requires a 15–25 cm incision and often involves spreading or even cutting the ribs, causing severe pain and a long recovery. Standard VATS uses 3–4 separate ports. Uniportal VATS uses just ONE — making it the least invasive chest surgery available today.

Dr. Prabhakaran U is trained in Uniportal VATS at Shanghai Pulmonary Hospital, China — the world's highest-volume VATS centre — and holds a Fellowship in Thoracic Oncology from Tata Memorial Hospital, Mumbai, India's premier cancer institution.

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Fellowship Credentials — Thoracic Surgery:
• Fellowship in MIS Thoracic Oncology, Uniportal VATS & RATS — Shanghai Pulmonary Hospital, China (2024)
• Fellowship in Thoracic Oncology — Tata Memorial Hospital (TMH), Mumbai (2023)
• MCh Surgical Oncology — Regional Cancer Centre (RCC), Trivandrum (2018–2021)

Advantages of Uniportal VATS

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Single 3–4 cm Incision

One tiny opening versus a 20 cm chest incision in open surgery — dramatically less trauma to muscles, nerves, and ribs.

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Significantly Less Pain

Pain is greatly reduced compared to open chest surgery. Most patients need only oral pain medication at home after discharge.

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Short Hospital Stay

Most patients are discharged in 2–3 days versus 7–10 days for open chest surgery — faster return home.

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Faster Recovery

Return to normal activities and work in 2–3 weeks. Open surgery patients need 6–8 weeks of recovery.

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Same Cancer Control

Equivalent lymph node removal and cancer clearance to open surgery — confirmed by multiple large clinical trials worldwide.

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Better Lung Recovery

Less disruption to chest wall muscles means breathing recovers faster and lung function returns more quickly.

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Less Blood Loss

Significantly reduced intraoperative blood loss — fewer transfusions needed and quicker physiological recovery.

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Excellent Visibility

HD camera provides a magnified, brightly lit view inside the chest — often better than direct vision in open surgery.

Uniportal VATS vs Open Surgery vs Robotic Surgery

Feature

Uniportal VATS

Open Thoracotomy

Robotic (RATS)

Incision size

3–4 cm (1 port)

15–25 cm

8–12 mm × 3–4 ports

Rib spreading

Yes

Post-op pain

Mild–Moderate

Severe

Mild–Moderate

Hospital stay

2–3 days

7–10 days

2–4 days

Return to work

2–3 weeks

6–8 weeks

2–3 weeks

Blood loss

Minimal

Significant

Minimal

Cancer control

Equivalent

Standard

Equivalent

3D vision

HD 2D camera

Direct vision

3D magnified ×10

Instrument reach

Standard

Full manual

Superior (360° wrist)

Cost

Moderate

Lower equipment

Higher

Which is Better — VATS or Robotic Surgery?

Both Uniportal VATS and Robotic Surgery (RATS) are excellent minimally invasive approaches with equivalent cancer outcomes. Uniportal VATS uses conventional instruments through a single port and is the preferred approach in most cases — offering excellent results at moderate cost. Robotic RATS offers superior 3D vision and instrument articulation, which is especially useful in complex resections or anatomically challenging cases. Dr. Prabhakaran is trained in both techniques and selects the best approach for each individual patient based on tumour size, location, and anatomy.

Who is Eligible for Uniportal VATS?

Suitable Candidates

Early-stage lung cancer — Stage I and Stage II
Selected Stage IIIA patients after tumour board review
Tumours not involving major blood vessels or central airways
Adequate lung function (assessed by pulmonary function tests)
No previous extensive chest surgery (relative)
Mediastinal tumours (thymoma, neurogenic tumours)
Pleural effusions requiring drainage or biopsy
Lung nodules requiring resection and diagnosis

Assessment Before Surgery

Every patient is assessed individually. Dr. Prabhakaran reviews your CT chest, PET-CT scan, pulmonary function tests (PFTs), and bronchoscopy results before recommending surgery. A multi-disciplinary tumour board discussion may be arranged for complex cases.

When VATS May Not Be Suitable

Very centrally located tumours involving main bronchus or vessels
Stage IIIB or IV lung cancer (usually treated with systemic therapy)
Severely impaired lung function
Extensive pleural adhesions from previous surgery or infection
Significant chest wall invasion

In such cases, Dr. Prabhakaran will discuss the best alternative approach — which may be robotic surgery, open surgery, or non-surgical treatment such as stereotactic radiotherapy (SABR) or medical oncology.

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Dr. Prabhakaran U performs Uniportal VATS at KG Hospital, Coimbatore — equipped with advanced video thoracoscopic systems. Call +91 90826 99710 to arrange an assessment.

Recovery After Uniportal VATS

Hospital Stay After VATS

Most patients are discharged 2–3 days after Uniportal VATS. A chest drain (tube) is placed at the end of surgery to drain any fluid or air — it is typically removed on Day 1–2 once output is minimal, after which most patients can go home.

Is Uniportal VATS Painful?

Pain after Uniportal VATS is significantly less than open chest surgery. Most patients describe discomfort as mild to moderate, well-controlled with oral pain tablets. Common sensations include a dull ache at the incision and shoulder tip pain — this is referred pain from the diaphragm irritated by residual gas, and resolves within 2–4 days. It does not indicate a problem with the lung.

Exercises After VATS Surgery

Deep breathing: 10 slow deep breaths every hour when awake — started same day as surgery
Incentive spirometer: 10 times every 1–2 hours to keep lungs expanded and prevent infection
Cough support: Hold a pillow firmly over your incision and cough to clear secretions — do not suppress coughs
Shoulder rolls: Gentle shoulder and arm movements from Day 2 to prevent stiffness
Walking: Short walks encouraged from Day 1 — increase distance daily
Avoid heavy lifting (>2 kg) for 4–6 weeks

When Can I Return to Work?

Desk / sedentary work: typically 2–3 weeks after surgery
Light manual work: 4 weeks
Heavy manual or physical work: 6 weeks
Your surgeon will confirm at your follow-up visit based on your recovery progress

Diet After VATS

Day 1–2: Clear fluids — water, coconut water, light soups
Day 3–5: Soft diet — idli, khichdi, curd rice
After discharge: Normal diet, small frequent meals
High protein foods (eggs, dal, paneer, chicken) support healing
Avoid alcohol for at least 4 weeks

Follow-Up Schedule

1–2 weeks: Wound check & pathology report review
1 month: Clinical review, further treatment discussion if needed
3 months: CT chest scan
Every 3–6 months for 2 years, then annually

Warning Signs — Seek Help Immediately If:

Sudden worsening breathlessness at rest
Fever above 38.5°C
Coughing up bright red blood
Wound redness, pus, or opening
Severe chest pain not controlled by medication

Frequently Asked Questions — Uniportal VATS

What is Uniportal VATS and how is it different from standard VATS?

Standard VATS uses 3–4 separate small incisions. Uniportal VATS uses just ONE incision of 3–4 cm through which both the camera and all surgical instruments are passed. This single-port approach means even less wound pain, a smaller scar, and faster recovery — while achieving the same cancer removal and lymph node harvest as multi-port VATS or open surgery.

Is Uniportal VATS painful?

Pain after Uniportal VATS is significantly less than open chest surgery. Most patients describe it as mild to moderate, well-controlled with simple oral pain medication. Shoulder tip pain (referred pain from diaphragm irritation by residual gas) is common but resolves within 2–4 days. The vast majority of patients are pleasantly surprised by how little pain they experience compared to what they expected.

Who is eligible for Uniportal VATS lung surgery?

Most patients with Stage I and Stage II lung cancer are candidates. Suitability depends on tumour size, location, proximity to major vessels and central airways, lung function (PFTs), and general fitness. Dr. Prabhakaran assesses each patient individually with CT, PET-CT scan, and pulmonary function tests before recommending the best surgical approach.

How long is the hospital stay after Uniportal VATS?

Most patients are discharged 2–3 days after Uniportal VATS, once the chest tube is removed and breathing is stable. Compare this to 7–10 days for open chest surgery. Longer stays may be needed for complex resections or if complications arise, but these are uncommon with minimally invasive surgery.

How long does the VATS surgery take?

A VATS lobectomy (removal of a lung lobe) typically takes 1.5–2.5 hours under general anaesthesia. Segmentectomy or wedge resections may take less time. You will be under anaesthesia throughout and will not be aware of the procedure.

Will I lose lung function after VATS lobectomy?

Some reduction in lung capacity occurs after lobectomy (lobe removal), but the human lung has significant reserve. Most patients adapt well as the remaining lung gradually compensates. Segmentectomy (removing only the affected segment rather than the whole lobe) is increasingly preferred for smaller tumours and preserves even more function. Breathing exercises help optimise recovery.

What is the chest tube after VATS and when is it removed?

A chest drain (thin flexible tube from your side connected to a sealed bottle) is placed at surgery to drain any air or fluid from around the lung. It is checked daily and removed once drainage is minimal — typically Day 1–2 after VATS. Most patients are discharged within 24 hours of tube removal. The removal takes only a few seconds and is briefly uncomfortable but not painful.

When can I return to work after VATS surgery?

For desk or sedentary work, most patients return in 2–3 weeks. For light manual work, around 4 weeks. For heavy physical or manual work, 6 weeks is recommended. Your surgeon will advise you at your follow-up appointment based on your specific operation and recovery progress.

Is Uniportal VATS available in Coimbatore?

Yes. Dr. Prabhakaran U performs Uniportal VATS at KG Hospital, Coimbatore. He is fellowship-trained at Shanghai Pulmonary Hospital, China — one of the world's highest-volume VATS centres — and Tata Memorial Hospital, Mumbai. Call +91 90826 99710 to arrange a consultation.

Can I fly after VATS surgery?

Short flights (under 1 hour) are generally safe from 2 weeks after surgery. Long-haul flights should be avoided for 4–6 weeks and require specific clearance from your surgeon, as cabin pressure changes can occasionally affect the healing lung. Individual assessment is important before any long-distance travel.

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