Anesthesia considerations for thoracoscopy

Similar to laparoscopy, thoracic surgery has been revolutionized by the minimally invasive approach. Thoracoscopy is no longer only a diagnostic procedure, but is increasingly used for achieving minimally invasive thoracic surgery. The rapidly expanding applications of video-assisted thoracic surgery could mean that one third to one half of thoracic surgical procedures that previously required open thoracotomy will be performed thoracoscopically. Perioperative management is satisfying because the benefit is readily apparent if one had seen the same procedure performed via a thoracotomy. This procedure presents challenges to the anesthesiologists in carefully evaluating the patient, choosing anesthetic technique, patient monitoring, and maintenance of cardiorespiratory function in the presence of pneumothorax and a variety of coexisting disease states as well as providing postoperative care. The anesthetic technique must be planned with the physiological changes that occur during thoracoscopy in mind. Further research and experience in thoracoscopy will help anesthesiologists provide safer and more effective perioperative anesthesia in the future. As minimally invasive thoracic surgery becomes more popular, it is important to be familiar with the perioperative management of patients undergoing thoracoscopy.