title: Video assisted thoracoscopic surgery (VATS) in Asia--its impact and implications.
abstract: BACKGROUND
  Within a short period of time, video assisted thoracoscopic surgery (VATS) has revolutionised the practice of thoracic surgery. Most of the existing literature, however, is concentrated on the technical aspects.
  
  
  OBJECTIVE
  We examined the impact of VATS on our practice and its implications.
  
  
  METHODS
  We reviewed our thoracic case load two years before and two years after the introduction of VATS in our hospital.
  
  
  RESULTS
  We have witnessed a rapid and progressive increase in our thoracic case load since the introduction of VATS. With increased experience, proportionally more cases were performed using VATS compared to conventional surgical access. The increased case load covered a wide range of thoracic diseases with the majority for spontaneous pneumothorax and pleural diseases.
  
  
  CONCLUSIONS
  The higher case load is due to increased referrals which at least partly reflect earlier acceptance by both the patients and their physicians for surgical intervention. The changing indications for surgery and the high cost associated with VATS, however, could place extra demand on the healthcare, especially for some countries in Asia. Cost containment is therefore a high priority here. More research is greatly needed in this area.
authors.affiliation: Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
authors.forename: A P
authors.initials: AP
authors.lastname: Yim
mesh_terms: D001208:Asia; D003363:Cost Control; D006801:Humans; D020706:Laparoscopes; D018581:Technology Transfer; D013903:Thoracic Surgery / Q000295:instrumentation*; D020708:Thoracoscopes; D014743:Videotape Recording