General Principles of Thoracoscopic Surgery

Abstract

There is no doubt that the substantial benefit to the patient resulting from thoracoscopic surgery emanates, to a large extent, from the avoidance of a thoracotomy. Apart from the immediate consequences of thoracotomy which often precipitate cardiorespiratory decompensation and require postoperative ventilatory and inotropic support, the recovery period following a thoracotomy extends over a period of several months, particularly in elderly patients and those with co-existing cardiac disease. Post-thoracotomy pain, including intercostal neuralgia, is a very common occurrence. It detracts from the benefit of the operation and usually requires prolonged treatment or referral to pain clinics. In addition, scapular fixation to the chest wall and the development of a frozen shoulder are frequently encountered and necessitate active treatment.