Table 2. Method of inserting a thoracoscope in various situations.

Clinical situation	Method of inserting a thoracoscope
Pneumothorax	At least 100–200 mL of pleural space; puncture sheath should be placed directly
Large amount of pleural effusion	Directly insert the puncture sheath
Small amount of pleural effusion	Place the puncture sheath using ultrasound or fluoroscopy guidance; note that air can enter the chest through the puncture sheath. If the pleural effusion suction is difficult, pneumothorax can be induced using a special gas brooch under pressure control
Pleural adhesions lead to difficulty in artificial pneumothorax	Can be bluntly separated using Kelly forceps and fingers
Complete occlusion of the pleural cavity	Prohibition of medical thoracoscopy