Der Chirurg

, Volume 86, Issue 7, pp 711–721 | Cite as

VATS – Technik und Indikation

  • H.-S. Hofmann
CME Zertifizierte Fortbildung


Die „video-assisted thoracic (thoracoscopic) surgery“ (VATS) hat weltweit die Tätigkeit der Thoraxchirurgen revolutioniert und die Behandlung der Patienten verbessert. In den letzten Jahrzehnten hat sich die VATS enorm weiterentwickelt und macht heute in vielen thoraxchirurgischen Kliniken ca. 50 % der operativen Eingriffe aus. Die VATS ist weniger invasiv und ermöglicht so eine schnellere Erholung des Patienten. In den letzten 20 Jahren hat sich die VATS zu einer sicheren und effektiven Technologie in der Diagnostik und Therapie vieler thorakaler Erkrankungen entwickelt. Mit zunehmender Erfahrung konnten auch komplexere und technisch anspruchsvollere Eingriffe durchgeführt werden. Heute ist die VATS eine in vielen Fällen der Thorakotomie überlegene Technik.


Thoraxchirurgie Minimal-invasive Chirurgie Bronchialkarzinom Mediastinaltumoren Lungenmetastasen 

VATS – technique and indications


Video-assisted thoracoscopic surgery (VATS) has revolutionized the practice of thoracic surgeons and improved patient experiences and outcomes worldwide. The VATS approach has matured over the past decades and now accounts for approximately 50 % of all operations in specialized thoracic surgery units. The VATS procedure is less invasive and therefore allows a faster recovery of patients. Over the last 20 years VATS has developed into a safe and effective technique for the diagnostics and therapy of many thoracic diseases. With increasing experience thoracic surgeons can carry out more advanced and technically challenging interventions. Nowadays, VATS is the superior technique in many cases of thoracotomy.


Thoracic surgery Minimally invasive surgery Bronchial carcinoma Mediastinal neoplasms Lung metastases 


Einhaltung ethischer Richtlinien


H.-S. Hofmann gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.


  1. 1.
    Roviaro G, Varoli F, Vergani C et al (1998) Video-assisted thoracoscopic surgery (VATS) major pulmonary resections: the Italian experience. Semin Thorac Cardiovasc Surg 10:313–320PubMedCrossRefGoogle Scholar
  2. 2.
    Zheng Y, Gill R, Jayender J et al (2014) Image-Guided Video Assisted Thoracic Surgery (iVATS): a Phase II Clinical Trial. In: AATS, Annual Meeting. Toronto, CanadaGoogle Scholar
  3. 3.
    Ng CS (2014) Single-port thoracic surgery: a new direction. Korean J Thorac Cardiovasc Surg 47:327–332PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Zdichavsky M, Schmidt A, Luithle T et al (2014) Three-dimensional laparoscopy and thoracoscopy in children and adults: a prospective clinical trial. Minim Invasive Ther Allied Technol 27:1–7Google Scholar
  5. 5.
    Singer M, Endres J, Yetasook A et al (2013) Evaluation of 3-D laparoscopy to complete surgical skills tasks. In: Annual Meeting of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) BalitmoreGoogle Scholar
  6. 6.
    Das-Neves-Pereira J, Riquet M, Le-Pimpec-Barthes F et al (2010) Robotic surgery for lung cancer. In: Baik S (Hrsg) Robot surgery. Intech, Rijeka, S 135–148Google Scholar
  7. 7.
    Zhu L-H, Du Q, Chen L et al (2014) One-year follow-up period after transumbilical thoracic sympathectomy for hyperhidrosis: outcomes and consequences. J Thorac Cardiovasc Surg 147:25–28PubMedCrossRefGoogle Scholar
  8. 8.
    Gaensler EA, Carrington CB (1980) Open biopsy for chronic diffuse infiltrative lung disease: clinical, roentgenographic, and physiological correlations in 502 patients. Ann Thorac Surg 30:411–426PubMedCrossRefGoogle Scholar
  9. 9.
    Sugi K, Kaneda Y, Esato K (2000) Video-assisted thoracoscopic lobectomy achieves a satisfactory long-term prognosis in patients with clinical stage IA lung cancer. World J Surg 24:27–30 (discussion 30–21)PubMedCrossRefGoogle Scholar
  10. 10.
    Watanabe A, Koyanagi T, Ohsawa H et al. (2005) Systematic node dissection by VATS is not inferior to that through an open thoracotomy: a comparative clinicopathologic retrospective study. Surgery 138:510–517PubMedCrossRefGoogle Scholar
  11. 11.
    Soukiasian HJ, Hong E, Mckenna RJ Jr (2012) Video-assisted thoracoscopic trisegmentectomy and left upper lobectomy provide equivalent survivals for stage IA and IB lung cancer. J Thorac Cardiovasc Surg 144:S23–S26PubMedCrossRefGoogle Scholar
  12. 12.
    Casali G, Walker WS (2009) Video-assisted thoracic surgery lobectomy: can we afford it? Eur J Cardiothorac Surg 35:423–428PubMedCrossRefGoogle Scholar
  13. 13.
    Yan TD, Black D, Bannon PG et al (2009) Systematic review and meta-analysis of randomized and nonrandomized trials on safety and efficacy of video-assisted thoracic surgery lobectomy for early-stage non-small-cell lung cancer. J Clin Oncol 27:2553–2562PubMedCrossRefGoogle Scholar
  14. 14.
    Boffa DJ, Allen MS, Grab JD et al (2008) Data from The Society of Thoracic Surgeons General Thoracic Surgery database: the surgical management of primary lung tumors. J Thorac Cardiovasc Surg 135:247–254PubMedCrossRefGoogle Scholar
  15. 15.
    Goldstraw P, Crowley J, Chansky K et al (2007) The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM Classification of malignant tumours. J Thorac Oncol 2:706–714PubMedCrossRefGoogle Scholar
  16. 16.
    Yamamoto K, Ohsumi A, Kojima F et al (2010) Long-term survival after video-assisted thoracic surgery lobectomy for primary lung cancer. Ann Thorac Surg 89:353–359PubMedCrossRefGoogle Scholar
  17. 17.
    Petersen RP, Pham D, Burfeind WR et al (2007) Thoracoscopic lobectomy facilitates the delivery of chemotherapy after resection for lung cancer. Ann Thorac Surg 83:1245–1249. (discussion 1250)PubMedCrossRefGoogle Scholar
  18. 18.
    Dienemann H, Hoffmann H (2012) VATS lobectomy in stageI lung cancer: standard or experimental procedure. Zentralbl Chir 137:228–233PubMedCrossRefGoogle Scholar
  19. 19.
    Eckardt J, Licht PB (2012) Thoracoscopic versus open pulmonary metastasectomy: a prospective, sequentially controlled study. Chest 142:1598–1602PubMedCrossRefGoogle Scholar
  20. 20.
    Schirren M, Bolukbas S, Oguzhan S et al (2014) Surgical therapy of lung metastases. Chirurg 85:833–842. (quiz 843–834)Google Scholar
  21. 21.
    Cerfolio RJ, Bryant AS, Mccarty TP et al (2011) A prospective study to determine the incidence of non-imaged malignant pulmonary nodules in patients who undergo metastasectomy by thoracotomy with lung palpation. Ann Thorac Surg 91:1696–1700. (discussion 1700–1691)PubMedCrossRefGoogle Scholar
  22. 22.
    Liu TJ, Lin MW, Hsieh MS et al (2014) Video-assisted thoracoscopic surgical thymectomy to treat early thymoma: a comparison with the conventional transsternal approach. Ann Surg Oncol 21:322–328PubMedCrossRefGoogle Scholar
  23. 23.
    Manoly I, Whistance RN, Sreekumar R et al (2014) Early and mid-term outcomes of trans-sternal and video-assisted thoracoscopic surgery for thymoma. Eur J Cardiothorac Surg 45:e187–e193PubMedCrossRefGoogle Scholar
  24. 24.
    Seong YW, Kang CH, Choi JW et al (2014) Early clinical outcomes of robot-assisted surgery for anterior mediastinal mass: its superiority over a conventional sternotomy approach evaluated by propensity score matching. Eur J Cardiothorac Surg 45:e68–e73. (discussion e73)PubMedCrossRefGoogle Scholar
  25. 25.
    Kimura T, Inoue M, Kadota Y et al (2013) The oncological feasibility and limitations of video-assisted thoracoscopic thymectomy for early-stage thymomas. Eur J Cardiothorac Surg 44:e214–e218PubMedCrossRefGoogle Scholar
  26. 26.
    Ruffini E, Mancuso M, Oliaro A et al (1997) Recurrence of thymoma: analysis of clinicopathologic features, treatment, and outcome. J Thorac Cardiovasc Surg 113:55–63PubMedCrossRefGoogle Scholar
  27. 27.
    Toker A, Sonett J, Zielinski M et al (2011) Standard terms, definitions, and policies for minimally invasive resection of thymoma. J Thorac Oncol 6:S1739–S1742PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Klinik für ThoraxchirurgieKrankenhaus Barmherzige Brüder RegensburgRegensburgDeutschland
  2. 2.Abteilung für ThoraxchirurgieUniversitätsklinikum RegensburgRegensburgDeutschland

Personalised recommendations