Video-Assisted Thoracoscopic Surgery

VATS has become the dominant approach for thoracic procedures, offering reduced surgical trauma, better visualisation, and faster recovery than open thoracotomy. Effective one-lung ventilation is a prerequisite for adequate surgical exposure in VATS, making lung isolation technique a critical anaesthetic decision. All VATS procedures in the trial are performed using a uniportal technique through a single approximately 4 cm incision at the fifth intercostal space. Despite being less invasive than open thoracic surgery, VATS is still associated with moderate-to-severe postoperative pain commonly occurring in the first 24–48 hours. Poor pain control after VATS can impair coughing, deep breathing, mobilisation, and pulmonary recovery, and may contribute to chronic post-thoracic pain syndromes. The trial enrols patients scheduled for elective VATS anatomical lung resection under general anaesthesia. Eligible VATS procedures in the trial include lobectomy, segmentectomy, wedge resection, and mediastinal tumour resection.