In 1973, I tried a new thoracoscopic treatment for the management of spontaneous pneumothorax. Adhesive agents, electrocoagulation, hot air, the neodymium: yttrium-aluminum garnet laser, intrathoracic devices, or various combinations of these have been used in the repair of more than 2,800 cases of ruptured bullae. Today, because the indications are sensitively defined by thoracography, the recurrence rate has decreased to less than 2%.