Malignant pericardial effusions are frequently symptomatic and usually
recur after aspiration. Surgical options include pericardiectomy and
transthoracic or subxiphoid pericardial window formation and, more rec
ently, thoracoscopic pericardial window formation. The authors report
their first four cases of laparoscopic creation of pericardial windows
. The treatment has been effective and minimally traumatic.