Minimally invasive surgical approaches for pneumothorax: evolution and current perspectives

Area of Science:

• Thoracic Surgery
• Minimally Invasive Procedures
• Pulmonology

Background:

• Pneumothorax management has evolved, with video-assisted thoracic surgery (VATS) becoming a preferred minimally invasive approach.
• Systematic reviews and randomized control trials show VATS is less invasive than traditional thoracotomy.
• Uniportal VATS offers advantages over thoracotomy, including reduced postoperative pain and improved cosmetic outcomes.

Purpose of the Study:

• To review the evolution and current status of minimally invasive surgical approaches for pneumothorax.
• To discuss the benefits and emerging trends in uniportal VATS for pneumothorax.
• To explore strategies for reducing recurrence and improving patient satisfaction in pneumothorax surgery.

Main Methods:

• Literature search of PubMed (1990-2025) for minimally invasive pneumothorax surgery.
• Systematic review of randomized control trials comparing VATS and thoracotomy.
• Analysis of current guidelines and international studies on surgical approaches for pneumothorax.

Main Results:

• Uniportal VATS is emerging as the preferred minimally invasive approach for pneumothorax.
• Uniportal VATS demonstrates less postoperative pain and better cosmetic results compared to thoracotomy.
• New devices for uniportal VATS may further reduce intercostal neuralgia and enhance cosmetic satisfaction.

Conclusions:

• Uniportal VATS is a highly effective and increasingly favored minimally invasive surgical approach for pneumothorax.
• Ongoing advancements in surgical techniques and devices are expected to further improve outcomes for pneumothorax patients.
• Addressing thoracic adhesions and optimizing intraoperative techniques are crucial for minimizing recurrence rates.