Thoracic diseases treated by keyhole surgery include lung, pleural and mediastinal diseases in addition to chest wall deformities.

A pneumothorax (collapsed lung) is usually dealt with by Video-assisted Thoracic Surgery (VATS), as well as bullous lung disease , which is a common finding in patients with chronic airways obstruction. Lung biopsies are obtained by VATS in patients with interstitial lung disease . Pulmonary nodules can be excised with the help of just two to three skin incisions of about two centimetres each.

The diagnostic and therapeutic problems of a pleural effusion complicating an infection or a malignant disease are solved with a thoracoscopy and -if required- a pleurodesis (fusion of the pleural space).

Mediastinal diseases including tumours and lymph nodes are amenable for thoracoscopic or mediastinoscopic investigation, and -if appropriate and technically feasible- for resection.

The Minimally Invasive Pectus Excavatum Repair is a relatively new surgical technique to treat the funnel chest with smaller incisions, avoiding the resection of rib cartilage.

Thoracic diseases (surgery)


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.