A total of 20 patients underwent bullectomy in the spontaneous pneumothorax between October 1993 and August 1994. The patients were divided into two groups: Control group; the patients who received with mid-axillary approach[n=10 , Experimental group; the patients who received with video-assisted thoracic surgery [n = 10 . The results were as follows; 1. The total sex distribution was male predominence [M :F=6:1 . Mean age of control group was 31.6$pm$ 10.1 age and experimental group was 24.3$pm$ 5.5 age. 2. The operative times were 117.0 $pm$ 32.6min in control group and 102.5$pm$ 38.4min in experimental group [not significant . 3. The indwelling period of postoperative chest tube and hospital stay were 4.5$pm$ 2.6 days and 8.3 $pm$ 1.8 days in control group, $1.5pm$ 0.5 days and 3.1 $pm$ 0.3 days in experimental group[p=0.0018, < 0.0001 . 4. In control group, injection times of pain-killer were 1.7$pm$ 0.7 times/day at operative day and 0.4$pm$ 0.6times/day at postoperative 1 day. In experimental group, there were 0.3$pm$ 0.7times/day at operative day and 0.1 $pm$ 0.3times/day at postoperative 1 day[p=O.O002 at operative day, not significant at postoperative 1 day .