Preparation of the patient (information, fasting status, shaving of the skin)

Premedication (optional)

Radiographic review is mandatory in each patient

Positioning of the patient

Intravenous line, nasal oxygen, ECG electrodes, blood pressure meter, oximeter

Choice of entry site on the basis of radiography/computed tomography or ultrasound/fluoroscopy ‘on the table’

Careful aspiration of fluids in case of pleural effusion

Insufflation (or spontaneous entrance) of air if necessary

Induction of pneumothorax if indicated

Careful local anaesthesia plus sedation as needed

Introduction of the trocar after a small skin incision

Inspection of the thoracic cavity using thoracoscope/pleuroscope

Documentation by photography or video

Insufflation of additional air/CO₂ into the pleural cavity if necessary

Section of adhesions preventing inspection if necessary

Obtaining of multiple biopsy samples

Control of bleeding

Talc pleurodesis if necessary after additional analgesics

Systematic suction drainage

Surveillance during recovery