Video-assisted thoracoscopy: a major advance in diagnosis and treatment of intrathoracic pathology

The diagnosis and treatment of intrathoracic disease often requires open thoracotomy. Patients who are immunocompromised, have poor pulmonary function, or have coronary artery disease may not tolerate this procedure well. With the advent of small video cameras, fiberoptics, and compatible instrumentation, thoracoscopy is now a viable option to open thoracotomy. This procedure is being performed with increasing frequency, and has achieved excellent results. The intrathoracic image, which previously was only available to the operating surgeon, is captured by a small video camera on the end of the scope. The image is projected simultaneously on several television monitors in the operative suite so that all members of the operative team can see exactly what the surgeon sees. By using such technologies, intrathoracic diagnostic and therapeutic procedures, which previously required some type of open thoracotomy, may now be performed through several small ports placed through diminutive surgical incisions. This article describes three case reports which demonstrate some of the successful applications of video-assisted thoracoscopy, and reviews the diagnostic and therapeutic indications for video-assisted thoracoscopy.