Thoracoscopy

Stephen R. Hazelrigg, MD, Traves D. Crabtree, MD, Michael J. Thomas, MD, Philipos K. Gebremedhin

Key Points

  • Video-assisted thoracic surgery (VATS) is useful for undiagnosed exudative pleural effusions to rule out malignancy.
  • VATS is very effective for empyema before the chronic fibrous phase, which occurs after 3-4 weeks.
  • VATS wedge resection for peripheral nodules provides definitive diagnosis.
  • VATS lobectomy appears safe and comparable to open lobectomy when done by experienced thoracic surgeons.
  • Lung volume reduction study may be done by VATS or sternotomy with comparative long-term outcome results in regard to lung function, 6-minute walk, and oxygen requirements.
  • VATS sympathectomy approaches 100% success for palmar hyperhidrosis.
  • VATS pericardectomy may provide advantages over a subxiphoid approach when the cause is benign; for malignant sources, the subxiphoid route is typically preferred.

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