The role of videothoracoscopy in the diagnosis and treatment of chest diseases.

Recent developments in video camera techniques, new instruments and advanced surgical techniques have increased the importance of thoracoscopy in both the diagnosis and therapy of diseases of the chest. Many diseases previously demanding open thoracotomy (i.e. spontaneous pneumothorax, biopsies of lung, pleura and mediastinum, several benign intrathoracic tumours, achalasia and reflux disease of the esophagus) can, today, be treated by video-assisted thoracic surgery with the same results as by using open procedures. The advantages of this technique compared to open thoracotomy include less operative trauma, less postoperative pain, good cosmetic results and shorter hospital stay. The drawbacks are the more difficult technique, demanding special education, the possibility of inadequate radicality in the treatment of malignant diseases and the necessity of longer operating time. The physician performing thoracoscopic surgery must also master the techniques of open procedures.