Anesthesia for Pediatric Thorascopic Surgery

Introduction Over the past decade advances in optical miniaturization systems used in endoscopes and computer assisted image guidance systems have led to an explosion of new minimally invasive surgical techniques for treating spinal deformities. Patients prefer minimally invasive surgery because such techniques give the promise of better cosmetic effect and reduced recovery times. Many of these techniques also promise decreased blood loss and better post-operative pulmonary function. Though equipment costs for start-up are steep, decreased hospital stay offers advantage to institutions as well. As newly developed techniques in minimally invasive surgery begin to be more widely used the pediatric anesthesiologist will have to develop improved and reproducible techniques to accommodate the technological advances. Selective lung ventilation in small children and a critical understanding of a host of new possible complications that can arise during these procedures needs to be appreciated. Furthermore as new therapeutic modalities develop which offer surgery to patients previously not candidates, the anesthesiologist is called upon to care for a new patient population of younger more severely debilitated children.