[In Process Citation]
Video-assisted thoracoscopic surgery is now recommended for the treatment of primary spontaneous pneumothorax. We studied the validity of this method at our general surgical department in a prospective group with regard to effectiveness and complication rate. The combination of thoracoscopic bulla resection with tetracycline pleurodesis resulted in a 100% recurrence-free rate of 28 pneumothoraces at a median follow-up of 19 months. We observed no intraoperative complications. We conclude that video-assisted thoracoscopic surgery is an effective treatment for primary spontaneous pneumothorax and can safely be carried out even in a general surgical unit. The legal aspects are discussed in detail.