ABSTRACT
References 301
1. INTRODUCTION
While minimal access surgery (MAS) in infants and children is a relatively new phenom-
enon, thoracoscopy has been performed in adults since the early 1900s (1). Jacobeus first
described its use in 1910 when he reported on a series of thoracoscopic pleural adhenolysis
in patients with tuberculosis using a rigid trocar and a cystoscope. Over the next 50 years
there was limited experience with thoracoscopy and few advances (2). The technique
remained limited to use in adults and consisted only of small biopsies of pleural-based
lesions and limited explorations (3). The complexity of the procedures performed was
restricted because of the simplistic nature of the optic system, light sources, and instru-
mentation. Procedures were limited to a single-port system with a working forceps
inserted through or around the telescope sheath.
