Because of technologic advances and improved postoperative recovery, endoscopic surgery has become the technique of choice for many thoracic surgical procedures<sup>6 Drott C. The history of cervicothoracic sympathectomy Eur J Surg 1994 ;  572 (suppl) : 5

Cliccare qui per andare alla sezione Riferimenti, 25 McKenna R.J. Video-assisted thoracic surgery update. The current status of video-assisted thoracic lobectomy Chest Surg Clin North Am 1998 ;  8 : 775-785

Cliccare qui per andare alla sezione Riferimenti</sup>; however, endoscopic visualization of intrathoracic structures requires retraction or collapse of the ipsilateral lung, which can have significant adverse effects on cardiopulmonary physiology. These cardiopulmonary changes can be further affected by the pathophysiologic changes associated with the disease process requiring the surgical procedure.

Because acute changes in cardiopulmonary function can compromise patient safety severely, a clear understanding of the dynamic interaction between the anesthetic–surgical technique and patient physiology is essential. This article discusses the effect of thoracoscopic surgery and the impact of various anesthetic interventions on cardiovascular and pulmonary physiology. In addition, some recommendations for “damage control” are made.