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Thoracoscopic apico-posterior transmediastinal approach for bilateral spontaneous pneumothorax

Department of Thoracic and Cardiovascular Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea 93-6, Ji-dong Paldal-gu, Suwon, Gyeonggi-do, 442-723, South Korea

*Corresponding author. Tel.: +82-31-249-7200; fax: +82-31-251-1755.

E-mail address: cscho{at}catholic.ac.kr; ebstein8{at}hitel.net (D.G. Cho).

Thoracotomic, trans-sternal or thoracoscopic approaches through transmediastinal access for contralateral lung are operative alternatives for bilateral pulmonary lesions. Video-assisted thoracoscopic surgery (VATS) for spontaneous pneumothorax (PTX) is now considered as a standard approach. Herein, we report a novel method of apico-posterior transmediastinal ipsilateral approach using VATS to perform simultaneous bilateral bullectomy in two young men with simultaneous bilateral spontaneous PTX. This new VATS access is technically feasible and may mitigate postoperative pain and avoid a secondary thoracic incision.

Key Words: Mediastinum; Pneumothorax; Thoracoscopy/VATS