Anesthesia for Video-Assisted Thoracoscopic Surgery

  • Edmond Cohen


Limited options to treat hypoxemia during one-lung ventilation (OLV) compared to open thoracotomy. Continuous positive airway pressure (CPAP) interferes with surgical exposure during video-assisted thoracoscopic surgery (VATS). Priority on rapid and complete lung collapse. Possibility of prolonged periods of OLV. Particularly during the learning phase of the surgical team. Decreased postoperative analgesic requirements compared to open thoracotomy. Surgical delay in treating major intraoperative hemorrhage. The option of doing minor VATS procedures with local or regional anesthesia.


Continuous Positive Airway Pressure Regional Anesthesia Lung Collapse Open Thoracotomy Thoracic Epidural Analgesia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1.  1.
    Sakula A. Carlo Forlanini, inventor of artificial pneumothorax for treatment of pulmonary tuberculosis. Thorax. 1983;38:326–32.PubMedCrossRefGoogle Scholar
  2.  2.
    Jacobaeus HC. The cauterization of adhesions in artificial pneumothorax treatment of pulmonary tuberculosis under thoracoscopic control. Proc R Soc Med. 1923;16:45–62.PubMedGoogle Scholar
  3.  3.
    Fischer GW, Cohen E. An update on anesthesia for thoracoscopic surgery. Curr Opin Anaesthesiol. 2010;23:7–11.PubMedCrossRefGoogle Scholar
  4.  4.
    Shiraishi T, Shirakusa T, Iwasaki A, et al. Video-assisted thoracoscopic surgery (VATS) segmentectomy for small peripheral lung cancers. Surg Endosc. 2004;18:1657–62.PubMedGoogle Scholar
  5.  5.
    Shaw JP, Dembitzer FR, Wisnivesky JP, Litle VR, Weiser TS, Yun J, et al. Video-assisted thoracoscopic lobectomy: state of the art and future directions. Ann Thorac Surg. 2008;85:S705–9.PubMedCrossRefGoogle Scholar
  6.  6.
    Demmy TL, Curtis JJ. Minimally invasive lobectomy directed toward frail and high-risk patients: a case-control study. Ann Thorac Surg. 1999;68:194–200.PubMedCrossRefGoogle Scholar
  7.  7.
    McKenna Jr RJ, Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1, 100 cases. Ann Thorac Surg. 2006;81:421–5.PubMedCrossRefGoogle Scholar
  8.  8.
    Weatherford DA, Stephenson JE, Taylor SM, Blackhurst D. Thoracoscopy versus thoracotomy: indications and advantages. Am Surg. 1995;61:83–6.PubMedGoogle Scholar
  9.  9.
    Park BJ, Zhang H, Rusch VW, Amar D. Video-assisted thoracic surgery does not reduce the incidence of postoperative atrial fibrillation after pulmonary lobectomy. J Thorac Cardiovasc Surg. 2007;133:775–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Cattaneo SM, Park BJ, Wilton AS, et al. Use of video-assisted thoracic surgery for lobectomy in the elderly results in fewer complications. Ann Thorac Surg. 2008;85:231–6.PubMedCrossRefGoogle Scholar
  11. 11.
    Williams A, Kay J. Thoracic epidural anesthesia for thoracoscopy, rib resection, and thoracotomy in a patient with a bronchopleural fistula postpneumonectomy. Anesthesiology. 2000;92:1482–4.PubMedCrossRefGoogle Scholar
  12. 12.
    Capan LM, Turndorf H, Patel C, et al. Optimization of arterial oxygenation during one-lung anesthesia. Anesth Analg. 1980;59:847–51.PubMedGoogle Scholar
  13. 13.
    Thomsen RW. Mediastinoscopy and video-assisted thoracoscopic surgery: anesthetic pitfalls and complications. Sem Cardiothorac Vasc Anesth. 2008;12:128–32.CrossRefGoogle Scholar
  14. 14.
    Tusman G, Bohm SH, Sipmann FS, Maisch S. Lung recruitment improves the efficiency of ventilation and gas exchange during one-lung ventilation anesthesia. Anesth Analg. 2004;98:1604–9.PubMedCrossRefGoogle Scholar
  15. 15.
    Fujiwara M, Abe K, Mashimo T. The effect of positive end-expiratory pressure and continuous positive airway pressure on the oxygenation and shunt fraction during one-lung ventilation with propofol anesthesia. J Clin Anesth. 2001;13:473–7.PubMedCrossRefGoogle Scholar
  16. 16.
    Ku C-M, Slinger P, Waddell T. A novel method of treating hypoxemia during one-lung ventilation for thoracoscopic surgery. J Cardiothorac Vasc Anesth. 2009;23:850–2.PubMedCrossRefGoogle Scholar
  17. 17.
    Ko R, Mcrae K, Darling G, et al. The use of air in the inspired gas mixture during two-lung ventilation delays lung collapse during one-lung ventilation. Anesth Analg. 2009;108:1092–6.PubMedCrossRefGoogle Scholar
  18. 18.
    Pfitzner J, Peacock MJ, McAleer PT. Gas movement in the non-ventilated lung at the onset of single-lung ventilation for video-assisted thoracoscopy. Anaesthesia. 2000;54:437–43.CrossRefGoogle Scholar
  19. 19.
    Narayanaswamy M, McRae K, Slinger P, et al. Choosing a lung isolation device for thoracic surgery: a randomized trial of three bronchial blockers versus double-lumen tubes. Anesth Analg. 2009;108:1097–101.PubMedCrossRefGoogle Scholar
  20. 20.
    Sugiura H, Morikawa T, Kaji M, et al. Long-term benefits for the quality of life after video-assisted thoracoscopic lobectomy in patients with lung cancer. Surg Laparosc Endosc. 1999;9:403–8.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Edmond Cohen
    • 1
  1. 1.Department of AnesthesiologyMount Sinai Hospital and School of MedicineNew YorkUSA

Personalised recommendations