Major thoracoscopic operations: pulmonary resection and mediastinal mass excision.

After the great success of laparoscopy in the field of abdominal surgery, the mini-invasive approach has opened interesting new possibilities in the field of thoracic surgery too. At present, in many centres, thoracoscopy is the surgical approach of choice for the treatment of recurrent pneumothorax, giant bullous lung disease, peripheral benign lesions. In very few centres a new phase is now starting, having the objective of verifying the validity of more complex thoracoscopic surgical operations. The authors describe their experience in performing major thoracoscopic operations such as excision of mediastinal masses and major pulmonary resections. The series includes 36 patients submitted to thoracoscopic excision of mediastinal masses and 113 patients submitted to video-thoracoscopic major pulmonary resections. Every kind of mediastinal lesion as well as every kind of major pulmonary resection was performed; the evidence of no intra-operative deaths confirms the possibility of a useful employment of the mini-invasive approach in this kind of surgery.