Pleuroscopy: indications and clinical considerations

Pleuroscopy is a minimally invasive procedure performed under moderate sedation that allows for direct visualization of the pleural space and therapeutic intervention. It is indicated in several clinical conditions, including diagnosis of unknown exudative pleural effusions, treatment of empyemas and pleurodesis to prevent re-accumulation of pleural effusions. It may be performed in an endoscopy suite without need for intubation, usually by a pulmonologist with training in endoscopic procedures. Pleuroscopy is generally safe and well tolerated, with few complications and very low associated mortality. It is usually considered in patients who may also be considered for VATS or tunneled pleural catheters, and often the decision of the appropriate technique is left to the clinician based on individual patient characteristics that would favor one modality over another