Thoracoscopic resection of mediastinal tumors and the thymus.

Videothoracoscopic techniques have proven their usefulness in dealing with pathology in the anterior mediastinum and should be considered in many cases as the procedure of choice. The surgeon's judgment, as always, is key in deciding which procedure is best suited for dealing with a particular lesion in any given patient. Thoracic surgeons need to be facile with these techniques in order to be able to provide the best approach for each patient. We need to be vigilant in observing and reporting results with these still relatively new procedures to ensure that outcomes are equivalent to the standard open procedures. The cost effectiveness of these minimally invasive procedures compared with the analogous open procedure still remains to be determined. Despite a shortened hospital stay for many of these procedures the equipment is more expensive and time in the operating room may be longer. It is safe to say, however, that many of these minimally invasive procedures are here to stay even if they fail to show a reduction in costs.