The Current Practice of Medical Thoracoscopy

What do we mean by the green zone? Here we describe the classical indications for thoracoscopy that every pulmonologist interested in this technique should be able to practice easily after proper training. On one hand thoracoscopy is a diagnostic tool improving the diagnostic yield of malignant diseases or nonmalignant pleural effusions such as tuberculosis in almost 100 % of the cases. On the other hand it is also an efficient therapeutic tool which allows control of pleural effusions responsible for breathlessness in patients with important such effusions and efficiently prevents further recurrence of pneumothorax by talc pleurodesis. As recently shown, talc if properly chosen and used is innocuous contrary to the talc used, for instance, in Brazil and North America. Talc pleurodesis under thoracoscopy is safe as recently shown in Europe by two large prospective studies in malignant pleural effusion and treatment of recurrence of spontaneous pneumothorax.