[Thoracoscopic methods in treatment of pulmonary emphysema]

Technical advances in the field of endoscopical surgery have widened the spectrum of thoracoscopic operations in the therapy of lung emphysema. Especially in patients who are severely disabled as a result of their reduced lung function, a less surgical trauma should result in better postoperative performance. Bullectomy, which was an integral part of the spectrum in thoracic surgery for a long time, should be performed in a minimally invasive way today. In the American literature, disappointing results have been published concerning laser resection of emphysematous lung tissue. As a result, this method should be abandoned. In contrast, lung volume reduction surgery in patients with diffuse emphysema has caused significant improvement in lung function. The initial approach to this method was a median sternotomy. However, recent experiences in several centers have demonstrated the feasibility and efficiency of a thoracoscopic procedure.