Pleuroscopy is typically a secondary diagnostic or therapeutic method for disorders affecting the pleural cavity. It is often performed following less invasive treatments such as ultrasound, computed tomography (CT) scans, and thoracentesis (the evacuation of pleural fluid with a needle).

Pleuroscopy has four indications in general:

Diagnosis: Commonly, pleuroscopy is used to examine the pleural cavity for abnormalities, such as infections, lung cancer, mesothelioma (cancer of the pleura), and lung cancer metastases. Bronchoscopy cannot provide views of the lung’s outer margins, although pleuroscopy can.

Biopsy: Pleuroscopy can give video-assistance guidance of a biopsy. The tissue sample can then be sent to the laboratory to determine whether cancer or infection is present. The biopsy can be conducted using fine-needle aspiration, core needle biopsy, or a newer technique known as cryobiopsy, in which frozen tissue is retrieved using forceps.

Fluid drainage: Pleuroscopy enables medical professionals to quickly drain fluid from patients with pleural effusion while visually examining the pleural cavity. The pleural fluid might also be sent to a laboratory to determine whether it contains cancer cells (called malignant pleural effusion).

Pleurodesis: During pleuroscopy, chemicals can be administered in patients with severe or recurring pleural effusion to bind the membranes and prevent fluid from reaccumulating. Pleurodesis is commonly performed on individuals with malignant pleural effusion, recurrent pleural effusion, or chronic or recurrent pneumothorax (collapsed lung)

There are only a few absolute and relative contraindications to pleuroscopy, making it a generally safe treatment.

Anyone with severe adhesions (i.e. sticking together) of the pleural membranes should never undergo pleuroscopy. Past respiratory infections, chest radiation, asbestosis, and difficulties from heart bypass surgery can cause pleural adhesions.

Less frequently, pleuroscopy may be contraindicated in patients with severe bleeding diseases, such as haemophilia, or significant respiratory insufficiencies, such as those seen in cystic fibrosis, stroke, and advanced chronic obstructive pulmonary disease (COPD).

Patients with an active respiratory illness, such as pneumonia, or those suffering from a recent heart attack should not undergo pleuroscopy until their condition has stabilized.

Even though pleuroscopy is considered less invasive, it bears the same risks as any surgical treatment, such as anaesthesia-related complications.

Depending on when the treatment is scheduled, your doctor may order bloodwork before your procedure, and the evening before, you will be urged to refrain from eating or drinking after midnight. You will be given an IV on the day of your procedure to receive drugs that will keep you at ease while it is being done. You may occasionally be put to sleep using an anaesthetic. Your doctor will start the EBUS bronchoscopy once you are at ease or asleep and insert the camera into your mouth.

Your doctor will inspect and obtain lung samples, typically with a small needle, using the camera and the ultrasound. A slight cough and sore throat are possible, but they should go away a day later.

The EBUS bronchoscopy is an outpatient procedure, and after a brief observation period, you will often be allowed to return home. After the treatment, you will need to arrange for someone to drive you home.

Although EBUS bronchoscopy is very safe, there is a minimal chance of complications, including bleeding from the biopsy, infection after the surgery, low oxygen levels during or after the procedure, and a slight possibility of lung collapse. Although all these side effects are curable, you might need to spend a short time in the hospital rather than leave after your treatment. Remember to let your doctor know if you’ve ever experienced complications from sedatives or anaesthesia.