Videothoracoscopic surgery

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Abstract
Although thoracoscopy has been used for diagnostic and minor therapeutic procedures for many years, there have been few reports of its use inperforming major intrathoracic procedures which have traditionally requiredformal thoracotomy. We report our initial experience in this field. Fiftypatients (M:F = 1.63:1, mean +/- SD age = 41.8 +/- 20.4 years, range =14-80) underwent 54 endoscopic intrathoracic operations. The procedurescarried out included wedge excision of solid pulmonary mass (10),pleurectomy (25), lung biopsy (14), and miscellaneous procedures (5). Undergeneral anaesthesia a laparoscope attached to a video monitor wasintroduced into the chest. One or two additional stab incisions were madeas needed for the introduction of standard surgical or endoscopicinstruments and staplers. There were no deaths. One patient developed asecond pneumothorax 7 days after endoscopic pleurectomy, necessitating openpleurodesis. All patients were discharged home between 2 and 11 days after surgery (mean +/- SD = 3.8 +/- 2.0 days). Endoscopic thoracic surgery is a safe and useful technique for certain cases. It merits further investigation and assessment.

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