Thoracoscopy

Fritz J. Baumgartner

Video assisted thoracoscopic surgery (VATS) is a new technique in which standard procedures are performed utilizing a video camera in a much less invasive manner than a standard thoracotomy. The advantage of this approach is a marked decrease in postoperative pain because of elimination of the standard thoracotomy.

An important principle to keep in mind is that the actual procedure should be the same as if it were performed with an open technique, i.e. the operation must not be compromised to suit the limits of endoscopic surgery. There have been reports, for example, of limited thoracoscopic resection of lung cancer resulting in early recurrence. One must never compromise the care of the patient to suit the technique.

The procedures which are particularly suited to thoracoscopy include apical bleb resection and pleural abrasion, lung biopsy, cancer and node biopsy, sympa-thectomy and esophagomyotomy.

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