Thoracic surgery: the irreversible evolution toward endoscopic surgery.

Endoscopic techniques have established themselves as an important means for reducing the traumatic impact of thoracic surgery on the patient. They considerably lighten postoperative pain and are cosmetically much more pleasing. Procedures such as lung biopsy, pericardial window, treatment of spontaneous pneumothorax, mediastinal benign tumour excision and sympathectomy have become routine, other such as oesophagectomy require further evaluation. Advanced procedures such as lobectomy and pneumonectomy require further clinical and technological development prior to a conclusive assessment.