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Key-Hole Surgery: Treatment, Procedure and Recovery

what is key-hole surgery

Thoracic Key-hole Surgery Facts!

  • Also known as video-assisted thoracoscopy surgery (VATS)
  • Uses small incisions and specialised instruments.
  • Majorly used for procedures like thoracic conditions like Lung Cancer, Lung Nodules, Thymoma and Thymic Tumours.
  • Compared to traditional open surgery, keyhole surgery results in smaller incisions, less scarring, and reduced postoperative pain.
  • Recovery time is often shorter.
  • Because of its varied benefits, this technique has gained popularity in recent years, with millions of keyhole surgeries performed worldwide annually.

What does Thoracic mean?

The term “thoracic” describes the region, or “thorax,” that lies between your neck and abdomen. It consists of a few blood vessels, lymph nodes, which are a component of your lymphatic system, and your:

  • Diaphragm
  • Esophagus
  • Heart and pericardium (protective sac around your heart)
  • Lungs
  • Ribs, thoracic spine and breastbone
  • Thymus gland (part of your immune system)

What is keyhole surgery?

Keyhole Surgery or Video-Assisted Thoracoscopy Surgery (VATS) is a type of surgery that, in comparison to open procedures, causes less damage to surrounding tissue by using small incisions and specialized instruments. In addition to reducing pain and leaving fewer scars, this method also speeds up recovery.

When performing keyhole surgery, large incisions can be avoided. The surgeon uses a device known as a thoracoscope which is a tiny tube with a light source and a camera is used to project images of the inside of chest onto a screen.

Traditional surgery was replaced by keyhole or thoracoscopic surgery due to the following benefits:

  • Quicker hospital discharge and healing
  • Less discomfort and bleeding following surgery
  • Less scarring

Who is an eligible candidate for Keyhole Surgery?

Case-by-case, surgeons determine if a patient is a candidate for minimally invasive thoracic surgery. When determining whether a patient is a candidate for minimally invasive surgery, surgeons take into account the patient’s anatomy, medical history, and specific condition. Consult your physician to see if you are a good candidate for this kind of surgery.

When is Keyhole Surgery done?

Key-hole surgery can be opted by the surgeon in the following conditions:

  • The diagnosis of chest cancers, such as lung cancer and pleural mesothelioma (a kind of cancer affecting the tissue surrounding the lungs), is made through tissue removal.
  • Lung surgery, including procedures to treat lung cancer and reduce the volume of the lung.
  • Techniques to empty the region surrounding the lungs of extra fluid or air.
  • Surgery to treat hyperhidrosis, a condition marked by excessive perspiration.
  • Surgery is used to treat issues with the oesophagus, the muscular tube that travels down the throat and into the stomach to carry food and liquids.
  • An esophagectomy is a surgical procedure used to remove all or part of the oesophagus.
  • Repair of a hiatal hernia, which occurs when the upper portion of the stomach pushes through the diaphragm’s opening and into the chest.
  • The thymus gland, a tiny organ located just behind the breastbone, is removed during a procedure known as a thymectomy.
  • Specific operations involving the diaphragm, ribs, spine, and heart.

Types of Keyhole Surgery or VATS Surgery

Keyhole procedures are undertaken to minimise harm to the surrounding tissue, which helps our patients recover from surgery quicker and with less discomfort.

Our thoracoscopic specialist offers the following range of keyhole procedures:

Video-Assisted Thoracoscopic Surgery (VATS): VATS is a versatile minimally invasive technique used for various thoracic procedures, including lung biopsies, lobectomies, and pleural interventions. Surgeons make small incisions and use a camera and specialized instruments to visualize and operate within the chest.

Robotic-Assisted Thoracic Surgery: Robotic surgery involves a surgeon controlling robotic arms with precision to perform procedures with enhanced dexterity. It is commonly used for complex procedures like lung resections, thymectomies, and oesophagal surgeries.

Laparoscopic Surgery: While primarily used for abdominal procedures, laparoscopic techniques can also be employed for certain thoracic conditions, such as hiatal hernia repairs involving the diaphragm and lower oesophagus.

Uniportal VATS: Uniportal VATS is a newer variation of VATS where all instruments and the camera are introduced through a single small incision. It’s used for lung surgeries and offers a potentially even less invasive approach.

Thoracoscopic Esophagectomy: This keyhole surgery is used to remove part of or the entire oesophagus in cases of oesophagal cancer. It combines laparoscopic and thoracoscopic approaches for a minimally invasive procedure.

Transcervical Thymectomy: This technique is employed for thymectomy, the removal of the thymus gland, and is suitable for treating thymoma and myasthenia gravis.

Endobronchial Interventions: Minimally invasive techniques can be used to treat conditions within the bronchial tubes, such as removing obstructions, placing stents, and taking biopsies.

Thoracoscopic Sympathectomy: This procedure is used to treat hyperhidrosis, or excessive sweating, by interrupting the sympathetic nerve signals responsible for sweating.

Minimally Invasive Repair of Chest Wall Deformities: Pectus excavatum and pectus carinatum, chest wall deformities, can be corrected using minimally invasive techniques.

Endoscopic Interventions: These techniques are used to treat conditions like tracheal stenosis, involving the narrowing of the windpipe, and may involve the use of stents and laser therapy.

What does the Keyhole Surgery procedure involve?

VATS is performed in a surgical facility or hospital. To put you to sleep during the process, general anaesthesia is administered. During the procedure, you will lie on your nonsurgical side.

Based on the VATS procedure and thoracic condition, our surgeon:

  • Makes multiple incisions in your chest, ranging from a quarter to half an inch. Alternatively, they perform a uniport VATS (U-VATS) procedure with a single incision.
  • Inserts the scope device, which projects images onto a video screen showing the interior of your chest.
  • Puts surgical instruments through the other wounds.
  • Employs the video images as a guide to help remove the unhealthy organ or tissue.
  • Uses repositionable stitches or staples to seal the incisions.

Difference between thoracic Keyhole Surgery and Traditional thoracic surgery

Thoracic Keyhole Surgery, or VATS, differs significantly from traditional thoracic surgery. In VATS, small incisions and a video camera are used to access and visualize the thoracic cavity, while traditional thoracic surgery involves larger incisions and rib-spreading techniques. This is minimally invasive, resulting in reduced pain, shorter hospital stays, and quicker recovery times compared to the more invasive nature of traditional surgeries.

The use of this technique offers an advantageous approach for treating various thoracic conditions with less trauma and scarring, making it a preferred choice for many patients seeking a more comfortable surgical experience.

What is the recovery like post Keyhole Surgery?

The keyhole surgery recovery time for thoracic keyhole surgery can vary depending on the type of procedure, the patient’s overall health, and the specific condition being treated. However, keyhole surgeries are generally associated with shorter recovery periods compared to traditional open surgeries. 

Here’s a general overview of what to expect during the recovery after thoracic keyhole surgery:

  • Pain and Discomfort: While keyhole surgery is minimally invasive, some pain and discomfort can be expected, especially in the days immediately following the surgery. Pain management is an essential part of the recovery process, and your healthcare team will provide appropriate pain relief.
  • Incision Healing: Keyhole surgeries involve small incisions, resulting in smaller scars compared to open procedures. The incisions are usually closed with dissolvable sutures or adhesive strips. It can take a few weeks for the incisions to fully heal and for scars to fade.
  • Physical Therapy: In some cases, patients may benefit from postoperative physical therapy or rehabilitation to help regain strength, lung function, and mobility.

Keep in mind that individual recovery experiences can vary, so it’s essential to discuss your specific case and expected recovery timeline with your healthcare team. They will provide guidance tailored to your condition and procedure.


It’s crucial to follow your surgeon’s postoperative care instructions carefully. These instructions will include details about wound care, pain management, dietary restrictions, and any activity limitations. If you experience any unusual symptoms, such as increased pain, fever, or infection at the incision site, contact your healthcare provider promptly.

What are the benefits of Keyhole surgery?

Keyhole surgery is a minimally invasive procedure. This indicates that tiny incisions are made during it. Thoracotomy, or open chest surgery, requires more time to complete. To spread open the ribs and gain access to the chest, a large incision is necessary. This makes the healing process more difficult and drawn out.

The benefits of VATS consist of:

  • Reduced the possibility of bleeding out and needing a blood transfusion.
  • Less time spent in the hospital.
  • Less severe scarring and pain following surgery.
  • Quicker restoration of breathing capacity.
  • Reduced chance of complications or infection.
  • A prompt resume of regular activities.

Dr Taj Chowdhry – An expert in the field of Thoracic Keyhole Surgeries

Dr Taj Chowdhry is truly a trailblazer in the field of thoracic keyhole surgeries, with his expertise and innovative techniques saving countless lives. His dedication to constantly improving his craft and pushing boundaries has made him a leading expert in this specialized field. Patients can trust that they are in capable hands when under the care of Dr Taj, whose passion for helping others shines through in every procedure he performs.

Get in touch with him to discuss more.

What is lung cancer?

Lung cancer is a formidable adversary that affects the delicate tissues of our lungs. Lung cancer occurs when abnormal lung cells grow uncontrollably and form tumours. These tumours can interfere with the normal functioning of the lungs, making it difficult for them to carry out their vital tasks of oxygenating our blood.

There are two main types of lung cancer

Non-small cell lung cancer (NSCLC) – NSCLC is the most common type, accounting for 85% of cases.

Small cell lung cancer (SCLC). Although less prevalent, SCLC grows more aggressively and has a higher chance of spreading beyond the lungs.

Lung cancer symptoms

Lung cancer symptoms can differ relying on the stage and type of cancer. In the early stages, many people may not experience any noticeable symptoms. However, as the disease progresses, certain signs may begin to manifest.

  • One of the common lung cancer symptoms is a persistent cough that doesn’t disappear or worsen over time. This cough may produce blood or rust-coloured phlegm. 
  • Chest pain or discomfort can also occur, along with shortness of breath and wheezing.
  • Weight loss without trying and fatigue are other potential symptoms of lung cancer. Some people may develop recurrent respiratory infections like bronchitis or pneumonia. 
  • Additionally, hoarseness in the voice and swelling in the neck or face can indicate more advanced stages of lung cancer.

How is lung cancer diagnosed?

From non-invasive imaging tests to cutting-edge genetic analyses, here’s a comprehensive look at the diagnostic tools and methods used in identifying lung cancer:

Imaging Tests

X-rays provide a quick overview of lung health, highlighting any abnormalities requiring further investigation.

CT Scans: With detailed cross-sectional images, CT scans offer a closer look at lung structures, aiding in detecting tumours and growths.

MRI Scans: Employing powerful magnets and radio waves, MRI scans offer high-resolution images, enhancing the visibility of lung tissues for accurate diagnosis.


Tissue Biopsy: A small tissue sample is extracted from the lungs when a suspected lung cancer diagnosis needs confirmation. Pathologists meticulously analyze these samples under a microscope to determine whether cells are cancerous or benign.

Sputum Cytology

Sample Collection: Patients must cough up sputum (phlegm or mucus) for analysis.

Microscopic Examination: The collected sample is scrutinized under a microscope to identify abnormal cells, providing valuable insights into potential lung cancer presence.

Genetic Testing

Mutation Analysis: Genetic testing zeroes in on specific gene mutations linked to lung cancer, allowing doctors to tailor treatments to individual genetic profiles.

Targeted Treatments: Armed with genetic insights, medical professionals can devise treatments that precisely address the underlying genetic causes of lung cancer.

Lung cancer risk factors


  • Risk Increase: Smoking introduces harmful chemicals to your lung cells, fostering a fertile ground for cancerous growth.
  • Cessation Matters: Quitting smoking drastically cuts the risk, showcasing the potential for positive change.

Secondhand Smoke

  • Passive Impact: Inhaling smoke exhaled by others escalates the risk, even for non-smokers.
  • Protective Steps: Minimize exposure and safeguard your lungs.

Occupational Carcinogens

  • Risk Professions: Construction, mining, transportation—exposure to substances like asbestos ups the ante.
  • Safe Workspaces: Protective measures guard against harmful substances.

Genetics and Family History

  • Family Links: Close kin with lung cancer heighten the possibility of it occurring in your life.
  • Awareness is Key: Knowledge empowers proactive health measures.

Lung cancer treatment by stage

Lung cancer treatment varies depending on the stage of the disease. Lung cancer stages range from 0 to IV, with each stage indicating the progression and spread of cancer cells.

Surgery is often considered the primary treatment option in early-stage lung cancer (stage 0 or I). This involves removing the tumour and surrounding tissue. In certain cases, radiation therapy is recommended to target any remaining cancer cells.

A combination approach is typically used for locally advanced lung cancer (stage II or III). This may involve a combination of chemotherapy, radiation therapy, and surgery. Chemotherapy helps to kill cancer cells throughout the body, while radiation therapy targets specific areas affected by the disease.

In advanced lung cancer (stage IV), treatment focuses on managing symptoms and prolonging life. Options may include targeted therapies that specifically attack certain genetic mutations in cancer cells, an immunotherapy that boosts the immune system’s ability to fight cancer, chemotherapy to shrink tumours and reduce symptoms, and palliative care to improve quality of life.

Consult Dr Taj Chowdhry for lung cancer diagnosis & treatment

If you or someone you know is experiencing symptoms or has concerns about lung cancer, it is crucial to seek medical attention as soon as possible. Timely diagnosis and treatment can improve outcomes and increase the chances of a successful recovery.

Dr Taj Chowdhry, an experienced lung cancer diagnosis and treatment specialist, is here to help. With his expertise in this field, he can provide accurate diagnoses using state-of-the-art technology and develop a treatment plan that is tailored to each patient’s needs.

Schedule an appointment with Dr Taj today!

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