Thoracoscopy in the management of spontaneous pneumothorax

For many years, treatment of spontaneous pneumothorax (SP) has been a matter of debate. Since the introduction of videothoracoscopy, videothoracoscopic procedures have replaced thoracotomy as the ultimate procedure for treatment of complicated cases of SP in many institutes. However, the place of (video) thoracoscopy in SP has not been fully established yet. Satisfactory results have been published about several different combinations of bullectomy (Stapler resection, endoloop ligation, electrocoagulation, Nd-YAG laser, CO2 laser, argon beam coagulation) and pleurodesis (mechanical, chemical, pleurectomy). Until today, it remains obscure if bullectomy as well as pleurodesis are always necessary to prevent recurrence.