Video assisted thoracic surgery in children.

Area of Science:

• Pediatric surgery
• Thoracic surgery
• Minimally invasive procedures

Background:

• Video-assisted thoracic surgery (VATS) has a long history in pediatric care, initially limited to diagnostics.
• Technological advancements in optics, CO2 insufflation, single-lung ventilation, and vessel sealing have expanded VATS applications.
• VATS is now a standard of care for several pediatric thoracic conditions.

Purpose of the Study:

• To review the expanded indications for VATS in pediatric patients.
• To discuss techniques for selective lung ventilation during VATS.
• To outline surgical steps for various pediatric thoracic conditions managed with VATS.

Main Methods:

• Review of current literature and clinical practices regarding pediatric VATS.
• Discussion of technological enablers for VATS.
• Description of surgical techniques and indications.

Main Results:

• VATS is now indicated for complex procedures including lung resections and mediastinal tumor excision in experienced centers.
• Established indications include empyema, lung biopsy, mediastinal lymph node biopsy, and diaphragmatic hernia repair.
• VATS offers a minimally invasive approach for a wide range of pediatric thoracic surgeries.

Conclusions:

• VATS has evolved significantly, becoming a cornerstone of modern pediatric thoracic surgery.
• The technique's versatility and safety support its role in treating diverse pediatric thoracic pathologies.
• Continued advancements promise further expansion of VATS applications in children.