Video-assisted blebectomy using a flexible scope and a bleb implement

We describe herein our new technique of performing video-assisted thoracic surgery (VATS) using a flexible scope and a bleb implement which allows for a reduction in the risk of overlooking small and Bat blebs in patients wit h a spontaneous pneumothorax (SP), This technique was performed in 26 conse cutive patients with a SP, A skin incision about 18 mm long was made in the area over which the patients had specified preoperatively, and meticulous observation of the apex and superior segment was performed using a bleb imp lement. Partial pneumonectomy with endoscopic staplers and laser ablation w ere carried out for pleural lesions. We found that VATS combined with a fle xible scope and a bleb implement resulted in better visibility for detectio n and removal of any small and flat blebs.