Medical thoracoscopy is commonly used to diagnose pleural diseases but is traditionally performed in the presence of pleural effusion to allow safe access to the pleural space. In patients without effusion (“dry space”), access becomes technically challenging, often delaying diagnosis or necessitating alternative biopsy methods. To address this gap, a study evaluated the safety and diagnostic effectiveness of performing thoracoscopy in dry pleural spaces using an optical trocar.
In a retrospective review of 226 procedures, 54 dry-space thoracoscopies were analyzed. Direct visualization with an optical trocar enabled successful pleural access and biopsy in all cases, although adhesiolysis was required in 62% of patients. Diagnoses included organizing pleuritis (59.3%) and malignancy (24.1%), with a malignancy detection sensitivity of 100% and no significant intra-procedural…
