Pneumothorax surgery: History, current data, and outlook, advantages and disadvantages according to the routes used

Spontaneous pneumothorax, whether idiopathic or secondary, remains a frequent condition with a high risk of recurrence. Surgery, combining resection of the bullae and pleurodesis, aims to prevent this recurrence. Over the years, surgery has undergone a number of advances, notably in terms of approach, from the large Thoracotomy to the era of minimally invasive approaches. The advent of video-assisted thoracic surgery (VATS) has supplanted thoracotomy thanks to lower morbidity, reduced postoperative pain and faster recovery, without compromising recurrence rates. The uniportal approach (Uniportal-VATS), a recent evolution of VATS, offers comparable or even superior results in terms of postoperative comfort and aesthetics, while preserving safety and efficacy. The future of pneumothorax surgery lies in optimizing these minimally invasive approaches, tailored to each individual patient, with the aim of reducing recurrence and improving postoperative quality of life.