[Surgical video-thoracoscopy].

Abstract

Surgical video thoracoscopy represents a new surgical approach to thoracic disease. Its objective is to limit thoracotomy trauma to the pleural wall and at the same time to eliminate the consequences of post-thoracotomy pain and post-operative respiratory dysfunction. There are certain indications which are already accepted as the gold standard, others still require validation and the inverse that certain interventions will probably be excluded from the domain of video thoracoscopy with acquired experience. The best indications are: the treatment of spontaneous pneumothorax in a young person, lung biopsy, the excision of peripheral parenchymal nodules of uncertain aetiology, the diagnostic approach to mediastinal adenopathy notably nodes which are inferiorly situated and inaccessible to mediastinoscopy or anterior mediastinotomy, the debridement of purulent pleurisy and/or haemothorax, the initial exploration before thoracotomy of a pulmonary tumour accompanied by a pleural effusion which may be minimal or irregularities of the parietal pleura, a thoracic sympathectomy, pleural symphysis for pleural tumour pathology, the pleuropericardial fenestration in cases of double pathology, pleural and pericardial requiring both a diagnostic approach and symphysis.