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<p>Thoracoscopy in local anesthesia (TLA) is performed using a&#xa0;rigid or semi-rigid technique via one small trocar with a&#xa0;diameter of 6–8 mm or two trocars of 4 mm diameter with the patient under mild analgosedation in spontaneous breathing. The aim of this method is to diagnose exudative pleural effusions of unknown etiology by inspecting the pleural space and taking a&#xa0;pleural biopsy or to perform talc poudrage in cases of malignant pleural effusions or recurrent pneumothorax. The TLA is also suitable for treating stages&#xa0;I and&#xa0;II pleural empyema. Due to its low invasiveness, the method can also be used in old patients with multiple comorbidities. An operating room and an anesthesia team are not required. Video-assisted thoracoscopic surgery (VATS) with the patient under general anesthesia using a&#xa0;double lumen endotracheal tube or non-intubated VATS (NIVATS) is not necessary for diagnosis of simple pleural effusion or talc poudrage. The TAL is highly efficient, cost-effective, safe and resource saving. The method can be performed by interventional pulmonologists or thoracic surgeons.</p>

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Thorakoskopie in Lokalanästhesie

  • 期刊论文

  • 发表日期：

    2026年7月17日

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  • Ralf Heine

摘要

Thoracoscopy in local anesthesia (TLA) is performed using a rigid or semi-rigid technique via one small trocar with a diameter of 6–8 mm or two trocars of 4 mm diameter with the patient under mild analgosedation in spontaneous breathing. The aim of this method is to diagnose exudative pleural effusions of unknown etiology by inspecting the pleural space and taking a pleural biopsy or to perform talc poudrage in cases of malignant pleural effusions or recurrent pneumothorax. The TLA is also suitable for treating stages I and II pleural empyema. Due to its low invasiveness, the method can also be used in old patients with multiple comorbidities. An operating room and an anesthesia team are not required. Video-assisted thoracoscopic surgery (VATS) with the patient under general anesthesia using a double lumen endotracheal tube or non-intubated VATS (NIVATS) is not necessary for diagnosis of simple pleural effusion or talc poudrage. The TAL is highly efficient, cost-effective, safe and resource saving. The method can be performed by interventional pulmonologists or thoracic surgeons.