The operative thoracoscopy commonly referred to as video-assisted thoracoscopic surgery (VATS).

Under thoracoscopy means the endoscopic examination of the Pleuraspaltes. It is used for diagnostics (Pleuroskopie) or for operational purposes. The operative thoracoscopy commonly referred to as video-assisted thoracoscopic surgery (VATS). Thoracoscopy can be carried out in an endoscopic department under local anesthesia in conscious patients, while VATS requires general anesthesia and is carried out in the operating theater. In both methods, a pneumothorax is brought about a better overview of the pleura. Indications thoracoscopy is used for diagnosis of exudative pleural effusions and various pleural and lung diseases in which non-invasive techniques have been unsuccessful. Pleurodesis in patients with recurrent malignant effusions “Breaking up loculations” in patients with empyema The diagnostic accuracy for malignant diseases and tuberculosis of the pleura is 95%. Among the indications for VATS include correction of a spontaneous primary pneumothorax Bullectomie and lung volume reduction surgery for emphysema wedge resection Lungenparenchymbiopsie include In some medical centers, Lobectomie and even pneumonectomy to the rarer indications for VATS extirpation of benign mediastinal tumors, biopsy and staging studies in esophageal carcinoma, sympathectomy in severe hyperhidrosis or causalgia and traumatic injuries of the lungs, pleura and diaphragm. Contraindications The contraindications are the same as in Pleurapunktionen. An absolute contraindication is Adhesive obliteration of pleural biopsies are relatively contraindicated in patients with highly vascularized cancer, severe pulmonary hypertension and severe bullous lung disease. Procedure Although thoracoscopy is performed by some pulmonologists that VATS is a domain of thoracic surgery. Both processes are similar to the application of a pleural drainage; through a skin incision, a trocar is inserted into an intercostal space through which the thoracoscope will be introduced. Additional sections allow the use of a video camera and other instruments. After a thoracoscopy a pleural drainage is needed usually for 1-2 days. Complications The complications are the same as for Pleurapunktionen. These include: Postprozedurales fever (16%) Pleural cracks cause an air leak (2%) and / or subcutaneous emphysema (2%) Tu include the serious but rare complications bleeding perforation of the pulmonary gas embolism patients have a risk for complications of general anesthesia ,

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