VATS: the age of maturity

In 1585, Tullio Cesare Aranzi used the focused light source for endoscopic examination of nasal cavity passing through the flask with water. Nevertheless, the founder of endoscopy is considered Phillip Bozzini who realised the “Leichtleiter”, an aluminium tube illuminated by candles and equipped with a mirror to reflect the image and light to visualise the urogenital tract in 1806. In 1901, Georg Kelling carried out the first experimental laparoscopy and thoracoscopy. Sir Francis Richard Cruise performed the first thoracoscopy in humans in 1865 overlooking the pleural cavity of a patient with a pleuro-cutaneous fistula. Thoracoscopy and laparoscopy were established as standard methods by Hans Christian Jacobabaeus in 1910. Since 1991, when Giancarlo Roviaro performed the first VATS lobectomy in Milan, several techniques for mini-invasive lung resection have been described (1). The development of major Video-Assisted Thoracic Surgery (VATS) surgery has almost two decades. At present, many complex thoracic surgical procedures can be safely performed by VATS, with the well-known advantages of smaller wounds, less pain, shorter hospital stay, and with as good outcomes compared with open surgery.