Keywords

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.

Advanced procedures in medical thoracoscopy are best described as nonroutine. They are interventions associated with greater complexity and lie somewhere between the medical procedure of thoracoscopy and the surgical procedure of VATS. The current advanced indications as described in the literature include sympathectomy and pericardial window. At the present time, thoracoscopic sympathectomy is minimally invasive and is an accepted intervention for patients with a variety of autonomous nervous system disturbances. Patients with essential hyperhidrosis as well as highly selected subjects with other defined disorders can be symptomatically improved with this procedure. They can be performed by interventional pulmonologists, but it must be noted that when performed as a “medical thoracoscopy” they should be categorized as an advanced technique—a “red zone” procedure. A pericardial window can be performed at thoracoscopy, as previously described in the literature. However, VATS should be considered as the gold standard, and the dedicated chapter in this book is to remind the reader of the historical aspects and limits of medical thoracoscopy. For these advanced procedures expert skills are mandatory from performing the basic procedures, simulated training, and hands-on training under the supervision of an experienced trainer.