Ultrasound guidance for medical thoracoscopy: a novel approach.
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.
Hersh
Craig P
CP
Division of Pulmonary and Critical Care Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA.
Feller-Kopman
David
D
Wahidi
Momen
M
Garland
Robert
R
Herth
Felix
F
Ernst
Armin
A
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*