Modified Chest Wall Pulley for Lung Excision during Single-Incision Thoracoscopic Surgery for Primary Spontaneous Pneumothorax.

We reported the feasibility of single-incision thoracoscopic surgery bullectomy using a chest wall pulley for lung excision (PulLE) in patients with primary spontaneous pneumothorax (PSP). PulLE has many merits including comfort of manipulation, cosmetic advantages, etc., compared to other procedures. However, our method was utilized for relatively straightforward cases. The PulLE was contraindicated for PSPs with multiple or comprehensive bullae. Therefore, we developed the modified PulLE (mPulLE) to treat such cases in February 2015. Although one chest wall pulley is placed in the thoracic cavity for a PulLE, two are used for an mPulLE. Herein, we describe the mPulLE technique.