Following the great success and wide acceptance of laparoscopic surgery, th
e mini-invasive approach has been adopted for use in thoracic surgery. Thor
acoscopic surgery is gaining acceptability as the procedure of choice for t
he treatment of recurrent pneumothorax and bullous lung disease, peripheral
benign and malignant lesions, diffuse pulmonary infiltrates, mediastinal a
nd pleural lesions, esophageal surgery, and major pulmonary resections for
primary lung tumors. We present the 4-year experience of a general surgery
service that extended the use of its advanced laparoscopic skills to the pe
rformance of thoracoscopic surgery in 80 patients. Using thoracoscopy, we p
erformed biopsy or excision of pulmonary lesions (23 patients), spontaneous
pneumothorax (14 patients), thoracic sympathectomy (41 patients), and Hell
er's esophagomyotomy and pericardiotomy (1 patient each). The results are e
xcellent, and we believe the procedures presented in this series, and simil
ar ones, can be accomplished safely and successfully by well-trained laparo
scopic surgeons.