Thoracic videoassisted surgery (VATS) is usually performed under general anesthesia (GA), muscle relaxation, special airway management and one lung mechanical ventilation. Lately, some studies show, that at least some of VATS procedures can be performed equally safe without GA, rough double lumen tubes (DLT) and perserving spontaneous ventilation. Non-intubated techniques are considered as a step to quick recovery and early discharge after thoracic surgery. In the following explanation we are going to discuss the pathophysiology of open pneumothorax and spontaneous breathing that must be taken into account, options for early recovery and economic costs of non-intubated procedures.
Key words: Nonintubated VATS, rebreathing, mediastinal shift