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Preparation of the patient (information, fasting status, shaving of the skin)
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Premedication (optional)
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Radiographic review is mandatory in each patient
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Positioning of the patient
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Intravenous line, nasal oxygen, ECG electrodes, blood pressure meter, oximeter
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Choice of entry site on the basis of radiography/computed tomography or ultrasound/fluoroscopy ‘on the table’
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Careful aspiration of fluids in case of pleural effusion
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Insufflation (or spontaneous entrance) of air if necessary
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Induction of pneumothorax if indicated
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Careful local anaesthesia plus sedation as needed
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Introduction of the trocar after a small skin incision
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Inspection of the thoracic cavity using thoracoscope/pleuroscope
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Documentation by photography or video
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Insufflation of additional air/CO2 into the pleural cavity if necessary
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Section of adhesions preventing inspection if necessary
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Obtaining of multiple biopsy samples
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Control of bleeding
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Talc pleurodesis if necessary after additional analgesics
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Systematic suction drainage
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Surveillance during recovery
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