Figure 4.

Pleurodesis with abrasion using a cleansing pad can be performed with instruments positioned at different angles, such as a linear endoscopic grasp to approach the apex (4A), and a long, curved clamp to approach other regions (4B). In all of the cases, we performed abrasion pleurodesis along with administering minocycline, but we did not perform pleurectomy. The specimen was removed through the small wound (4C). Resection with a stapler was shown to be as feasible as in conventional multi-portal thoracoscopic surgery (4D).