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June 1, 1994

Cardiothoracic Surgery

Author Affiliations

Allegheny General Hospital and The Allegheny Campus of the Medical College of Pennsylvania, Pittsburgh

JAMA. 1994;271(21):1658-1660. doi:10.1001/jama.1994.03510450030016

Cardiothoracic surgery continues to be a dynamic field with new developments arising from a variety of sources. In the last 2 years the necessity for making a major incision for a thoracic operation has been challenged, and in many instances it has been replaced by video-assisted thoracoscopic surgery. This technique uses several small incisions (1 to 2 cm) on the chest wall through which a thoracoscope and endoscopic instruments can be introduced and manipulated. An image is captured on a video monitor by a miniature camera attached to the thoracoscope. The advantages of video-assisted thoracoscopic surgery over thoracotomy are decreased postoperative pain, shorter hospitalization, and faster patient recovery.1 The technique does require single-lung ventilation with collapse of the ipsilateral lung, and therefore general anesthesia and a double-lumen endotracheal tube are needed.

Video-assisted techniques have replaced the standard open thoracotomy approaches for most simple thoracic operations. Procedures that are now

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