Introduction

Thoracoscopy nearly has a century long history (1912). It is only now that technological advance has enabled move beyond diagnostic and experimental to the therapeutic and even the norm. Most operations, considered as part of the repertoire of the thoracic surgeon and requiring access through a sternotomy or thoracotomy, are within the range of alternative and putatively less destructive thoracoscopic techniques. Initially, operations were conducted with local anesthetic blockade at the point of access, either local anesthetic infiltration or some form of single or extended intercostal nerve blockade (e.g. paravertebral space injection). Hypoxia and accumulation of carbon ...