Thoracoscopic Water Pleurectomy for the Treatment of Recurrent Spontaneous Pneumothorax

We describe a new technique for thoracoscopic pleurectomy for the treatment of spontaneous pneumothorax. This is performed by percutaneous subpleural infiltration of 0.9% saline solution from the second to the seventh or eighth intercostal space, the so-called water pleurectomy. The extrapleural infiltration allows gentle separation of the parietal pleura by the division of its natural adherence to the endothoracic fascia. This technique reduces the trauma of the procedure and decreases bleeding. Technical details and preliminary results are reported. (C) 2014 by The Society of Thoracic Surgeons