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Collapsed Lung

Pneumothorax
Collapsed Lung — Diagnosis & Surgical Treatment, London

A pneumothorax — commonly called a collapsed lung — can be frightening and, without treatment, has a significant chance of happening again. Thorough investigation and keyhole surgery to treat pneumothorax and significantly reduce the risk of recurrence. Dr Okiror is co-PI at GSTT for the NIHR-funded PRO-SEAL trial (ISRCTN15099654). Catamenial pneumothorax page →

Last reviewed: April 2026 · Dr Lawrence Okiror FRCS(CTh) FRCSEd(CTh) · GMC 6150382

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Condition

Pneumothorax — a collapsed lung — occurs when air enters the pleural space. Primary spontaneous PTX affects healthy individuals; secondary occurs with underlying lung disease; catamenial PTX recurs with menstruation

Recurrence risk

Without surgery, spontaneous pneumothorax has a recurrence rate of up to 50%. Keyhole bullectomy and pleurodesis significantly reduces this risk and is recommended after a second episode

PRO-SEAL trial

Dr Okiror is co-PI at GSTT for the NIHR-funded PRO-SEAL trial (ISRCTN15099654) — evaluating suction, endobronchial valve placement, and blood patch pleurodesis for persistent air leak in secondary PTX

About the Condition

What is a
Pneumothorax?

A pneumothorax occurs when air leaks into the space between the lung and the chest wall, causing the lung to collapse partially or fully. It can occur spontaneously — most often in tall, slim young men — or as a result of an underlying lung condition, injury, or medical procedure.

Symptoms typically include sudden sharp chest pain and breathlessness. A small pneumothorax may resolve on its own, but larger ones require treatment to re-expand the lung. More importantly, without surgical treatment, a spontaneous pneumothorax has a recurrence rate of up to 50%.

Keyhole (VATS) surgery removes the small blebs or blisters on the lung surface that cause the air leak, and creates a controlled adhesion between the lung and chest wall to prevent recurrence. This is the most effective way to prevent a pneumothorax from happening again.

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Types of Pneumothorax
  • →Primary spontaneous — no underlying lung disease; typically in young, tall, slim individuals
  • →Secondary spontaneous — caused by underlying lung disease such as COPD or asthma. Pleural disease →
  • →Traumatic — following chest injury or medical procedure
  • →Catamenial — recurs around menstruation, caused by thoracic endometriosis. Thoracic endometriosis →
Symptoms to look out for
  • →Sudden sharp chest pain, often one-sided
  • →Breathlessness or difficulty breathing
  • →Rapid heart rate
  • →Dry cough
  • →Feeling anxious or unwell
Keyhole Surgery — What to Expect

Surgery is performed under general anaesthesia through small keyhole incisions. The operation typically takes under an hour. Most patients spend a few days in hospital and return to normal activities within two to three weeks. Recurrence rates following surgery are significantly lower than with non-surgical management alone.

Frequently Asked Questions

Questions About
Pneumothorax

Common questions from patients referred with a pneumothorax or collapsed lung. For catamenial pneumothorax linked to the menstrual cycle, see the thoracic endometriosis page →

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Or call Jo Mitchelson:
020 7952 2882

Do I need surgery after a first pneumothorax?
Not necessarily. A first pneumothorax is often managed conservatively — with observation, aspiration, or a chest drain depending on its size. Surgery is generally recommended after a second episode, or after a first episode in certain high-risk situations such as in pilots, divers, or patients with a very large pneumothorax. Dr Okiror will review your specific circumstances and advise clearly.
What does surgery for pneumothorax involve?
Surgery is performed by keyhole (VATS) technique under general anaesthesia. Through small incisions, the small blebs or bullae on the lung surface responsible for the air leak are removed, and then a pleurodesis is performed — causing the lung lining to adhere to the chest wall and significantly reducing the chance of a further collapse.
How long is recovery after pneumothorax surgery?
Most patients spend a few days in hospital following keyhole surgery. Return to desk-based work is typically possible within two to three weeks. More physical activity takes a little longer. Dr Okiror will give clear guidance tailored to your job and lifestyle.
Can a pneumothorax come back after surgery?
Surgery significantly reduces the risk of recurrence compared to non-surgical treatment. While no procedure guarantees zero risk, keyhole surgery with pleurodesis is the most effective intervention currently available to prevent a further pneumothorax.
What is catamenial pneumothorax?
Catamenial pneumothorax is a collapsed lung that occurs cyclically around the time of menstruation. It is caused by thoracic endometriosis — endometrial tissue in the chest cavity, most commonly on or through the diaphragm. Surgical treatment involves keyhole removal of endometrial deposits and repair of any diaphragm defects. Full thoracic endometriosis page →
Do I need a GP referral?
No. Self-referrals are welcome for private consultations. Appointments are typically available within 2–3 days. If you have recently been discharged from hospital following a pneumothorax and would like a specialist review, contact us directly.

Book a Consultation

Appointments within 2–3 days. Self-referrals welcome. Surgery at London Bridge Hospital and Lister Hospital Chelsea.

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Jo Mitchelson, Private PA  · 020 7952 2882 · pa@lungsurgeon.co.uk

St Thomas' Hospital #1 UK · Guy's Hospital #2 UK · London Bridge Hospital #10 UK · Newsweek World’s Best Hospitals 2026

Related Conditions & Pages

Bullectomy & Giant Bulla

Keyhole surgery for a pneumothorax associated with a giant bulla, recurrent bullous-disease pneumothorax, or a bulla with complications

 Pleural Disease

Pleural effusion, empyema, mesothelioma and thoracic endometriosis

 Thoracic Endometriosis

Catamenial pneumothorax — collapsed lung linked to the menstrual cycle
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