Needlescopic video-assisted thoracic surgery pleurodesis for primary pneumothorax.

Conventional video-assisted thoracic surgery (VATS) is already well established as the approach of choice for definitive surgical management for primary pneumothorax. However, VATS itself is a constantly evolving technique. The needlescopic VATS (nVATS) approach uses the existing chest drain wound as a working port and adds only two 3-mm ports to provide equally effective pleurodesis as conventional VATS. Staple resection of bullae or blebs plus complete mechanical parietal pleural abrasion is achievable using nVATS. By potentially reducing morbidity for the individual patient, the nVATS approach may lower thresholds for surgical candidacy-even for first episodes of primary pneumothorax.