Video-assisted thoracic surgery: our first 20 cases.

Video-assisted thoracic surgery has been performed in 20 patients at the Medical Center of Delaware. Operations included seven pulmonary wedge resections, one mediastinal procedure, and 12 pleural procedures. In all cases, a definitive diagnosis was made or the lesion was removed. One postoperative atypical pneumonia occurred. One patient whose wedge resection proved to be squamous cell carcinoma on frozen section underwent a formal thoracotomy and lobectomy. Estimated savings in the eight patients who formerly would have undergone a thoracotomy incision is estimated at $30,000 for room cost alone. We foresee a markedly expanded role for this technique in major pulmonary resections, esophageal procedures, and cardiac surgery in the near future.