Surgical video thoracoscopy

Surgical video thoracoscopy represents a new surgical approach to thoracic disease. Its objective is to limit thoracotomy trauma to the pleural wall a nd at the same time to eliminate the consequences of post-thoracotomy pain and post-operative respiratory dysfunction. There are certain indications w hich are already accepted as the gold standard, others still require valida tion and the inverse that certain interventions will probably be excluded f rom the domain of video thoracoscopy with acquired experience. The best ind ications are: the treatment of spontaneous pneumothorax in a young person, lung biopsy, the excision of peripheral parenchymal nodules of uncertain ae tiology, the diagnostic approach to mediastinal adenopathy notably nodes wh ich are inferiorly situated and inaccessible to mediatinoscopy or interior medistinotomy, the debridement of purulent pleurisy and/or haemothorax, the initial exploration before thoracotomy of a pulmonary tumour accompanied b y a pleural effusion which may be minimal or irregularities of the parietal pleura, a thoracic sympathectomy, pleural symphysis for pleural tumour pat hology, the pleuropericardial fenestration in cases of double pathology, pl eural and pericardial requiring both a dignostic approach and symphysis.