Thoracoscopic pleural abrasion

Pleural abrasion represents a surgical technique to achieve pleural symphysis in order to prevent recurrence in spontaneous pneumothorax. It can be performed either by thoracotomy or VATS. Pleural abrasion is obtained by scrubbing the parietal pleura until a uniform aspect of bloody pleura is achieved. Various tools can be used for this purpose, such as meshes, gauzes, sponges, the electro-surgical tip cleaner or pleural abraders especially fit for VATS. The recurrence rate of pneumothorax after pleural abrasion vary from 0% to 10%, according the type of surgical approach, with thoracotomy having the lowest rate of recurrences but the drawbacks of a more invasive approach. Considering the balance between effectiveness and risks, pleural abrasion performed by VATS is considered today as the procedure of choice for the treatment of spontaneous pneumothorax.