title: Advances in pleural diseases: what is the future for medical thoracoscopy?
abstract: OBJECTIVE
  Medical thoracoscopy provides the physician a window into the pleural space. The procedure allows biopsy of the parietal pleura under direct visualization with good accuracy. In addition, it achieves therapeutic goals of fluid drainage, guided chest tube placement, and pleurodesis.
  
  
  RESULTS
  Comparable diagnostic yield is achieved with the flexi-rigid pleuroscope even though pleural biopsies are smaller using the flexible forceps as compared to rigid thoracoscopy. Flexi-rigid pleuroscopy is extremely well tolerated and can be performed safely as an outpatient procedure. Biopsy quality can be further enhanced with accessories that are compatible with the flex-rigid pleuroscope such as the insulated tip knife and cryoprobe.
  
  
  CONCLUSIONS
  With more sensitive tools to image the pleura such as contrast-enhanced computed tomography, MRI, ultrasonography, PET, increased yield with image-guided biopsy as well as advances in cytopathology, what lies in the future for medical thoracoscopy remains to be seen. However, it is the authors' opinion that medical thoracoscopy will evolve with time, complement novel techniques, and continue to play a pivotal role in the evaluation of pleuropulmonary diseases.
authors.affiliation: aDivision of Respiratory and Critical Care Medicine, National University Hospital, Singapore, Singapore bClinical Medicine, Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Pyng
authors.initials: P
authors.lastname: Lee
authors.forename: Praveen N
authors.initials: PN
authors.lastname: Mathur
mesh_terms: D001706:Biopsy; D006801:Humans; D061705:Image-Guided Biopsy; D010995:Pleural Diseases / Q000175:diagnosis*; D020708:Thoracoscopes; D013906:Thoracoscopy / Q000379:methods