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Video-assisted thoracic surgery. Current state of the art
1Department of General Thoracic Surgery, University of Pennsylvania, School of Medicine, Philadelphia.
Objective:
The author reviews the current state of the art of video-assisted thoracic surgery in the context of modern thoracic surgical practice.
Summary Background Data:
Thoracoscopy has been a part of thoracic surgical practice for many years, but was used mainly for diagnosis of pleural disease. The development of laparoscopic cholecystectomy awakened a new interest in this technique and led to the development of many new therapeutic and diagnostic applications of video-assisted thoracic surgery.
Methods:
Current literature and the author's personal experience with more than 500 cases are reviewed.
Results:
Video-assisted techniques have proven useful for the performance of a broad spectrum of thoracic surgical procedures. Patients may experience less pain and have a shorter hospital stay after a video-assisted procedure. Definitive proof of less morbidity when compared with the analagous open procedure remains to be determined. Patient acceptance has been high, and most thoracic surgeons use these techniques in their practice.
Conclusions:
Video-assisted thoracic surgical procedures have made a significant impact on the practice of thoracic surgery. Advantages and disadvantages of specific procedures remain to be definitively determined. Surgeons have learned these techniques and have kept morbidity to acceptance levels during the learning phase. Where these techniques ultimately fit into the overall practice remains to be determined as more experience is gained.