THE DIVERSE POTENTIAL OF THORACOSCOPIC ASSISTED SURGERY

Thoracoscopy has been a part of thoracic surgical practice for many ye ars. The introduction of the camera chip and newer instrumentation has awakened a new interest in this technique and led to the development of video-assisted thoracic surgery (VATS), One hundred and seventy con secutive procedures performed on 158 patients are reviewed, Video-assi sted techniques have proven useful in a broad spectrum of thoracic sur gical procedures both diagnostic (n=90) and therapeutic (n=80), Hospit al mortality was 1.3%. Conversion to formal thoracotomy was required i n 2.5%, and re-exploration for bleeding in 0.6%, The technique was saf e and the incidence of complications acceptable, VATS was particularly helpful in diagnosing ''indeterminate'' pulmonary nodules (sensitivit y of 95%), interstitial lung disease (histological diagnosis in all), anterior mediastinal masses and post transplant pneumonitis, VATS may now be the surgical treatment of choice in those with spontaneous pneu mothorax, and it also proved useful in a variety of benign disorders, Its role in the management of empyaema is limited with a 57% conversio n rate. While pulmonary resections are feasible, its role in the thera peutic management of malignancy is questioned. Further studies are req uired to define the precise role of VATS in thoracic surgery.