Video-assisted thoracoscopic surgery for bilateral spontaneous pneumothorax in supine position: The use of a pillow beneath the back for intercostal space widening

We performed a single stage video-assisted thoracoscopic surgery for bilate ral spontaneous pneumothorax in the supine position with both arms abduced and the back slightly elevated using a pillow. While intercostal spaces wer e not open enough to insert a trocar, this procedure, not requiring the tro uble of placing patients in the lateral decubitus position, is beneficial f or the single treatment of bilateral thoracic disease.