Medical thoracoscopy

Abstract

Medical thoracoscopy, synonymous to pleuroscopy, refers to exploration of the pleural cavity in local anesthesia plus general sedation/analgesia. As opposed to video-assisted thoracoscopic surgery (VATS), general anesthesia or tracheal intubation is not necessary, and it can be performed either by trained pulmonologists or thoracic surgeons in a well-equipped endoscopy suite. Main indications are diagnosis of unexplained pleural effusions and treatment of recurrent pleural effusions or pneumothorax (pleurodesis, talc poudrage). Calibrated talc with particles no smaller than 10 μm (in order to prevent extrapleural dissemination with subsequent systemic complications) is mandatory whenever pleurodesis is attempted.