Medical thoracoscopy

Abstract

Medical thoracoscpy [MT] (pleuroscopy) is a minimally invasive procedure performed by using endoscopic telescope to visualize and evaluate the pleura, pleural space, mediastinum and the lung. Hans Christian Jacobeus (an internist that worked in Stockholm Sweden) is the first one to report the technique in 1910 (on the possibility to use cystoscopy in examination of the serous cavities)1. However MT is not polarized for the management of malignant and infectious pleural effusion in Europe until 1970s. Surgical thoracoscopy and Visual Assisted Thoracic Surgery (VATS) were developed by surgeon after the excellent success and result of laparoscopic surgery 3-7. MT differ from surgical thoracoscopy and VATS in many ways. MT is performed using the Jacobeus technique under conscious sedation, the ipsilateral lung is passively deflated, via a single or two sites of entry. It is performed by the pulmonary physician in an endoscopy suite or  procedure room using non disposable rigid (or semi-rigid) instruments7. Surgical thoracoscopy and VATS are performed under general anesthesia with double lumen endotracheal tube with single lung ventilation and need 2-4 sites of entry. They are performed by the surgeon in an operating theatre.

Keywords: pleuroscopy, pleural effusion, chylothorax, talc.