Medical thoracoscopy

Medical thoracoscopy is an important technique for assessment of undiagnosed exudative pleural effusion. It is also important in the management of pleural disease, benign or malignant. Standard equipment available from several manufacturers enables the procedure to be performed through a single port of entry, frequently under conscious sedation. With good patient selection, thoracoscopy is a highly successful and safe procedure. Adequate training is mandatory and a period of mentoring is highly recommended. In this paper we discuss the use of thoracoscopy for some benign and malignant conditions and reveal that controversy remains over issues including the optimum mode and agent for pleurodesis. In addition, opinions differ on the precise role of thoracoscopy for pleural infection. In this paper we discuss key background information necessary for the safe provision of thoracoscopy. We then undertake a review of recent literature addressing important aspects of this procedure.