Ricerc@Sapienza

in the last three decades, minimally invasive techniques have progressively gained acceptance, as
shown by the numerous studies published in the literature. Before the 1990s, video-assisted thoracoscopic
surgery (VATS) was considered feasible almost exclusively for the diagnosis of pleural diseases. The
availability of better instruments and endoscopic stapling devices allowed thoracoscopy to evolve into a new
“therapeutic era”. Nowadays, VATS is considered the approach of choice for the treatment of pneumothorax
and other lung, mediastinal and esophageal diseases, replacing traditional approaches as thoracotomy
and sternotomy. The use of ports through small incisions (one to three-four) for the camera and surgical
instruments allows the surgeon to explore the pleural cavity and work easily on the lung parenchyma. This
approach translates into less discomfort for the patient, reduced morbidity, shorten hospital stay and faster
functional recovery. The optimal treatment of pneumothorax certainly refers thoracoscopy as the approach
of choice maintaining the same indications as for open surgery.