Video-assisted Thoracic Surgery (VATS) is performed through two to three skin incisions, whilst hands and eyes are coordinated via a video-screen.

The treatment of pneumothorax and bullous lung disease implies firstly the identification and then excision of the diseased areas of lung with a so called endostapler. The same device, which is able to seal and cut the lung, helps to obtain biopsies for presumed interstitial lung disease , whenever a transbronchial attempt turns out to be inconclusive.

Pulmonary nodules of uncertain histology are excised to direct further treatment of these patients, which might then be medical (in case of diffuse metastic lung disease) or surgical (in case of solitary pulmonary metastases, lung primary).

Quality of Life is a major concern in patients with malignant pleural effusion , and a VATS procedure in conjunction with a pleurodesis (fusion of the pleural space) provides permanent palliation. The insertion of a so called Pleurx catheter enables these patients to be discharged usually on day one after their surgery.

The mediastinum is accessible to a Video-assisted mediastinoscopy if enlarged lymphnodes need further investigation, or if the local extent of a lung primary needs to be assessed.

Other indications for VATS are resection of mediastinal tumours of limited size and pericardial effusion (pericardial window, mostly due to an underlying malignancy).

The Minimally Invasive Pectus Excavatum Repair (or Nuss procedure) is a less invasive alternative to the "open" procedure, and involves the insertion of a retrosternal bar through three skin incisions of about three centimetres each.