Anaesthesia for a patient undergoing transthoracic endoscopic vagotomy

We describe the anaesthetic management of a patient who underwent transthoracic endoscopic vagotomy. One-lung ventilation was necessary to provide adequate surgical access. Potential intraoperative problems involved arterial oxygen saturation during one-lung ventilation, unequal intrathoracic pressures causing mediastinal displacement and inadvertent myocardial injury by surgical instruments and diathermy. The management of these problems and the benefits of endoscopic surgery to the patient are discussed.