Immediately following VATS surgery

Deep breathing and coughing are the most important things that you can do to speed up your recovery. There is a tendency to avoid these things due to chest discomfort following surgery. Our goal is to minimize your discomfort while encouraging you to cough up any secretions (phlegm). These efforts are important to prevent pneumonia.

Patients receive a small device called an incentive spirometer to help encourage deep breathing several times per hour. A respiratory therapist will show you how to use it.

In addition to the nerve blocks performed during surgery, you will be provided a multimodal approach to pain control. This means that we will use different types of medications to manage the pain. These will include a combination of non-narcotic and narcotic medications by mouth. Intravenous narcotics are available as needed, but our goal is to minimize their use. As you recover in the hospital and at home, your goal should be to minimize oral as well. While you may take an oral narcotic pill every 4-6 hours immediately following surgery, once your chest tube is removed and you are discharged from the hospital, we recommend you begin to gradually space out the doses to wean yourself off.

As long as you are taking narcotics, you will receive a stool softener daily. Narcotic consumption can contribute to constipation. In addition to stool softeners, other medications are available if you suffer from constipation following surgery.

Although most patients experience a reduced appetite after surgery, you are free to eat and drink. One side effect is nausea. You will be provided medication to reduce any stomach discomfort. Vomiting can be dangerous after surgery, so we ask that you avoid foods that may upset your stomach. If you are not hungry, we encourage you to drink fluids slowly until your appetite returns.

The day after surgery:

• • We aim to have the urinary catheter removed the day after surgery.
  • We will routinely stop any continuous IV fluids. We want you to be able to be out of bed as much as possible without the constraints or risks of IV tubes.
  • Our goal is to have you sitting in a chair for breakfast
  • You should walk the halls with assistance from the nursing staff and/or physical therapy on the day following surgery. Short, frequent walks are key to your recovery. Walking after surgery prevents problems such as pneumonia, constipation, and blood clots in your legs.
• We will remove the chest tube when the drainage output is low enough and there is no air leaking from the A specialist will test you for air leakage frequently by having you cough and will monitor the tube for bubbles. Usually, the tube is removed one to three days following surgery. Removing the chest tube is an indication of strong recovery and good progress. Most patients leave the hospital a few hours after tube removal or the next morning.

After surgery, you will receive supplemental oxygen. The goal is to wean the oxygen off in the days following surgery. Your oxygen saturation level is monitored to allow us to wean and remove the supplemental oxygen as long as your saturations are appropriate (above 92%).