title: Ultrasound guidance for medical thoracoscopy: a novel approach.
abstract: BACKGROUND
  Commonly, a pneumothorax is induced before medical thoracoscopy to facilitate safe entry into the pleural space.
  
  
  OBJECTIVE
  Evaluate the use of transthoracic ultrasound to locate a safe entry site for trocar placement during medical thoracoscopy without induction of a preprocedure pneumothorax.
  
  
  METHODS
  The study was designed as a prospective cohort study, performed in the setting of a tertiary care hospital with an active interventional pulmonology program. It included 20 consecutive patients referred for medical thoracoscopy.
  
  
  RESULTS
  Ultrasound identified entry sites in all 20 patients. All sites were successfully used, despite the presence of adhesions in 3 patients. There were no complications.
  
  
  CONCLUSIONS
  Ultrasound could safely and reliably identify entry sites for trocar placement during medical thoracoscopy, even in patients with pleural adhesions. The use of ultrasound may replace the practice of pneumothorax induction before medical thoracoscopy.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Craig P
authors.initials: CP
authors.lastname: Hersh
authors.forename: David
authors.initials: D
authors.lastname: Feller-Kopman
authors.forename: Momen
authors.initials: M
authors.lastname: Wahidi
authors.forename: Robert
authors.initials: R
authors.lastname: Garland
authors.forename: Felix
authors.initials: F
authors.lastname: Herth
authors.forename: Armin
authors.initials: A
authors.lastname: Ernst
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000601:surgery*; D011677:Punctures; D025321:Surgery, Computer-Assisted; D013525:Surgical Instruments; D013906:Thoracoscopy / Q000379:methods*