Proceedings of the International scientific and practical conference ―Synergy of Modern Science and Education‖ (February 2-4, 2026) / Publisher website: www.naukainfo.com. – New York, USA, 2026. - 324 p.

111 Pict. 3. Thoracoscopic fenestration of the pericardium. Thoracoscopic fenestration of the pericardium also belongs to minimally invasive interventions. It was performed in 24.56% of cases. The disadvantage of this intervention is the need for single-lung intubation and limited possibilities of its use in unstable patients with cardiorespiratory failure. This intervention can be performed at any stage of the disease. It is especially indicated in the presence or suspicion of a pathological process in the pleural cavity or mediastinum for performing simultaneous interventions. Contraindications to thoracoscopic fenestration of the pericardium are severe cardiorespiratory failure, the presence of an adhesive process in the pleural cavity, and the possibility of a bacterial etiology of exudative pericarditis. The use of pericardioscopy allows to significantly increase the efficiency and informativeness of minimally invasive interventions. Its use during suxiphoid extrapleural pericardiotomy allows to visualize almost all surfaces of the heart and, in some cases, the great vessels. Transpleural pericardioscopy allows to revise the pericardial cavity and that surface of the heart, which are located in the white fenestration. The use of pericardioscopy during minimally invasive interventions allowed to increase the efficiency of intraoperative diagnostics and etiological search