[Thoracoscopic diagnosis and therapy of spontaneous pneumothorax]

Thoracoscopy must be regarded as an obligatory procedure in the diagnosis and therapy of symptomatic spontaneous pneumothorax. In up to 81% of cases data obtained by thoracoscopy considerably influence therapy. Indication for surgery has to be weighed against endoscopic therapy (coagulation, laser and pleurodesis). Thoracoscopy should be performed at the first recurrence of an idiopathic spontaneous pneumothorax, unless the lung does not expand during suction drainage or recollapses after expansion.