Thoracoscopy has been recently established as an indispensable technique for diagnosis and treatment of
respiratory diseases. Although, thoracoscopy is usually applied under
general anesthesia by a surgeon, it can also be applied by a chest physician under
local anesthesia if the target is limited to
pleural diseases. The main objective of medical thoracoscopy under
local anesthesia is to establish a diagnosis of
pleural effusions by means of observation and biopsy in the thoracic cavity. Our main target diseases are the
pleuritis carcinomatosa,
malignant mesothelioma and tuberculous
pleuritis. These 3 diseases are the diseases with which medical thoracoscopy is most useful because they can be reliably diagnosed by biopsies and because early diagnosis and early treatment are essential. In case of the
pneumothorax, treatment with
bulla looping or
cauterization may be possible, but we do not treat
pneumothorax with medical thoracoscopy because it is impossible to approach and find air leaks of lesions located in or near blind spots such as the apex or mediastinal part In case of acute
emphysema, it is important to release adhesions and perform effective drainage using thoracoscopy as soon as possible since deposition of
fibrin tends to form quickly compartments that make drainage difficult. Scince medical thoracoscopy under
local anesthesia is rapid, easy, safe, and well-tolerated procedure with an excellent diagnostic yield, it is recommended as a diagnostic procedure for cases with
pleural diseases.