Historical developments
Thoracic surgery has an integral role in the management of pleural disease, augmented by significant advancements in both thoracic anaesthesia and operative techniques over the last century. Minimally invasive techniques, in particular, have evolved significantly since they were first performed in 1910 by H.C. Jacobeus using a modified cystoscope. At the turn of the twentieth century, this technique for intrapleural pneumolysis transformed operative treatment for tuberculosis (TB). However, over the following decades, advancements in the medical treatment for TB resulted in a decline in the number of procedures performed. This continued to decline until the advent of video‐assisted devices vastly widened applications in the management of pleural disease and developed into the current video‐assisted thoracic surgery (VATS). Increasingly, such keyhole advancements have allowed interventional pleural procedures to be carried out by chest physicians who perform such procedures under sedation in selected patients.
Thoracic surgery has evolved alongside the development of aseptic techniques, advancements in radiology, transfusion and monitoring techniques. However, the most profound changes to practice have resulted from developments in thoracic anaesthesia.
