Epidural for mini-invasive thoracic surgery: do we need a sledgehammer to crack a nut?

In thoracic surgery, big changes have taken place in the past three decades. Video-assisted thoracic surgery (VATS) was introduced only 25 years ago but has since rapidly evolved, going from three–four ports to two and finally just one: wide, disfiguring incisions have turned into minimal accesses, and the old concept of thoracoscopy has been recast from a diagnostic tool limited to pleural diseases to a full-operative surgical procedure capable of eradicating extensive pulmonary masses (1).