ABSTRACT
Since the introduction of minimally invasive surgical techniques to thoracic surgery in 1990, video-assisted thoracic surgery (VATS) has become a common technique for many operative procedures. When Cooper rekindled interest in the surgical treatment of diffuse emphysema, he used the median sternotomy, because it offered good access to both lungs with minimal postoperative complications and pain (1). At several institutions, surgeons utilizing minimally invasive techniques have shown that bilateral VATS appears to produce results that are comparable with those of a median sternotomy for lung volume reduction surgery (LVRS). In certain situations, a VATS approach to LVRS may be preferable. This chapter will review the indications for LVRS, present the results for the various LVRS procedures, describe the VATS technique for LVRS, and compare the published data for the bilateral VATS and the median sternotomy approaches.
