VIDEOTHORACOSCOPIC SURGERY

Although thoracoscopy has been used for diagnostic and minor therapeut ic procedures for many years, there have been few reports of its use i n performing major intrathoracic procedures which have traditionally r equired formal thoracotomy. We report our initial experience in this f ield. Fifty patients (M:F = 1.63:1, mean +/- SD age = 41.8 +/- 20.4 ye ars, range = 14-80) underwent 54 endoscopic intrathoracic operations. The procedures carried out included wedge excision of solid pulmonary mass (10), pleurectomy (25), lung biopsy (14), and miscellaneous proce dures (5). Under general anaesthesia a laparoscope attached to a video monitor was introduced into the chest. One or two additional stab inc isions were made as needed for the introduction of standard surgical o r endoscopic instruments and staplers. There were no deaths. One patie nt developed a second pneumothorax 7 days after endoscopic pleurectomy , necessitating open pleurodesis. All patients were discharged home be tween 2 and 11 days after surgery (mean +/- SD = 3.8 +/- 2.0 days). En doscopic thoracic surgery is a safe and useful technique for certain c ases. It merits further investigation and assessment.