The field of video-assisted thoracoscopic surgery (VATS) has evolved from our experience with laparoscopic procedures now routinely performed by the general surgeons. In the past we used rudimentary devices to peer into the chest; now we utilize advanced video technology, computers and high-tech electronics to perform many operations that formerly required traditional open surgery. In essence, video-assisted surgery allows the thoracic surgeon to accomplish the same goal as the comparable open procedure but with less pain, less scarring and a quicker recovery.