Thoracoscopy for Management of Lung Disease (Including Emphysema)

Thoracic applications for thoracoscopy or video-assisted thoracic surgery (VATS) remain many. Wedge resection for lung nodules and lung biopsy remains the most frequently performed VATS procedure. Thoracoscopy has been very valuable as a diagnostic technique for undiagnosed lung nodules and infiltrates. Using VATS for therapeutic resection of metastatic nodules remains controversial with potential adverse consequences. Recently there has been a great deal of interest and enthusiasm for VATS techniques in emphysematous patients. Surgical procedures such as resection of apical blebs and bullae have become standard. However, VATS volume reduction is aimed at a different segment of the emphysema population. The theoretic and potential surgical role in emphysema is discussed. VATS offers decreased pain and shortened hospital stays for many disorders and as such remains a valuable tool for the surgeon.