A 3-year-old girl with pectus excavatum successfully underwent exploration
using video-assisted thoracic surgery. A complete pericardial defect was id
entified. The lung was kept totally collapsed during the procedure using lo
w-flow (1 L/min), low-pressure (7 mmHg) carbon dioxide insufflation, This t
echnique is expected to be a safe adjunct to thoracoscopic procedures in in
fants and small children.