Thoracoscopy was developed by Jacobaeus in the early 1900s because a method was needed to break down adhesions in patients with pulmonary tuberculosis so that an artificial pneumothorax could be produced. Thoracoscopy was used extensively for this purpose until 1945, at which time streptomycin was introduced for the treatment of tuberculosis. In one report, the results in 1,000 patients in whom thoracoscopy was used to break down adhesions were detailed. Jacobaeus also published an early report on the use of thoracoscopy to localize and diagnose benign and malignant lesions of the pleura and pulmonary parenchyma.
After 1950, thoracoscopy was rarely performed in the United States, although some physicians in Europe continued to perform the procedure. During this period, thoracoscopy was used primarily to assist in diagnosing pleural effusions, although pleurodesis was sometimes attempted with talc or silver nitrate. A number of instruments were employed including rigid bronchoscopes, mediastinoscopes, flexible bronchoscopes, and specialized rigid fiber-optic thoracoscopes . Two older books provide state-of-the-art discussions on thoracoscopy before the advent of VATS, which has become available mainly since 1990.
The recent revival of thoracoscopy was made possible by the tremendous advances in endoscopic technology. The development of the charged coupling device and a silicon chip that is light sensitive led to the sufficient miniaturization of a video camera. When attached to a fiber-optic telescope, the video camera produces a well-defined, magnified image on a video monitor that allows the operating surgeon to work with an assistant. Previously, the surgeon had to hold the thoracoscope, and only he could look into it while working, which did not allow for the aid of an assistant and, therefore, limited the complexity of the procedures undertaken (12).
Source: Pleural Diseases 5th Edition (Lippincott Williams & Wilkins) 2007
After 1950, thoracoscopy was rarely performed in the United States, although some physicians in Europe continued to perform the procedure. During this period, thoracoscopy was used primarily to assist in diagnosing pleural effusions, although pleurodesis was sometimes attempted with talc or silver nitrate. A number of instruments were employed including rigid bronchoscopes, mediastinoscopes, flexible bronchoscopes, and specialized rigid fiber-optic thoracoscopes . Two older books provide state-of-the-art discussions on thoracoscopy before the advent of VATS, which has become available mainly since 1990.
The recent revival of thoracoscopy was made possible by the tremendous advances in endoscopic technology. The development of the charged coupling device and a silicon chip that is light sensitive led to the sufficient miniaturization of a video camera. When attached to a fiber-optic telescope, the video camera produces a well-defined, magnified image on a video monitor that allows the operating surgeon to work with an assistant. Previously, the surgeon had to hold the thoracoscope, and only he could look into it while working, which did not allow for the aid of an assistant and, therefore, limited the complexity of the procedures undertaken (12).
Source: Pleural Diseases 5th Edition (Lippincott Williams & Wilkins) 2007