Laparoscopic pericardiotomy, biopsy, and external drainage can be perf
ormed effectively in a safe and efficient manner for benign and malign
ant pericardial effusions. This technique, although minimally morbid,
allows for pericardiotomy with biopsy and placement of large drains un
der visual control. In this article, we describe the surgical techniqu
e, including external drain placement. We discuss our experience with
laparoscopic drainage of an infected benign effusion with tamponade in
a patient with chronic renal failure. A diagnostic laparoscopic peric
ardiotomy in a patient with penetrating lower thoracic trauma is also
described. Potential advantages and disadvantages of the laparoscopic
approach are discussed.