VATS offers numerous advantages for patients with pulmonary disease. Diagnosis and management of numerous pulmonary and other thoracic conditions can now be treated with a less invasive approach. Because of this advance in technology, the ICU patient population is changing. With this advance, there will be fewer thoracotomies performed, resulting in fewer ICU admissions. Thoracoscopy offers hope for those critically ill patients who cannot withstand a diagnosis or interventional surgical procedure to treat their illness.