Videothoracoscopic techniques were utilized in managing 88 consecutivepatients. The series was composed of 36 patients with pneumothorax, 44cases of single and 9 of multiple pulmonary nodules and 1 patient withdiffuse lung disease. In 14 cases (15.9%) conversion to open thoracotomywas necessary while in the remaining 74 patients the procedure (30blebectomies, 2 bullectomies, 37 wedge resections, 6 lobectomies and onemultiple biopsies) were carried out as planned. In each lobectomy and insix wedge resections an accessory small incision was necessary; we consideronly this video-assisted thoracic surgery (VATS). Benign disease, asidefrom the blebs and bullae, was found in 12 cases of solitary pulmonarynodules and in 1 case of multiple lesions, while malignant lesions weredetected in 31 patients. Primary carcinoma was diagnosed in nine casesafter a wedge resection had been performed on a suspicious solitary nodule.In two of these wedge resection had to suffice because of poor lungfunction, while in the remaining seven cases, a lobectomy was carried outthrough an open thoracotomy in two patients, and in five cases VATS wasattempted successfully in four, while in one case a formal thoracotomy wasnecessary due to bleeding. Solitary metastases were found in 14 patientsand were managed by 12 wedge resections and 2 lobectomies. Seventy-onepatients (97.3%) had an uneventful postoperative course while 2 (2.7%) hadonly minor complications. No recurrences were observed, however follow-upis limited. Videothoracoscopy techniques are very useful and are goodalternatives to conventional thoracotomy in managing cases of pneumothorax,benign pulmonary lesions and in taking biopsies.(ABSTRACT TRUNCATED AT 250WORDS)