Versatility of disposable scopes and their use in flexible, semi-rigid and rigid thoracoscopy

Thoracoscopy is a centennial technique that has enabled physicians to thoroughly explore the pleural cavity and perform a wide range of diagnostic, staging, and therapeutic interventions, from pleural biopsies to complex pulmonary resections. With the global rise in lung diseases, there has been a resurgence of interest in medical thoracoscopy, and market forecasts predict significant growth in the coming decade. This creates a unique opportunity to establish thoracoscopy as a universally accessible and affordable procedure. This report will examine the procedural and instrument limitations, technical challenges, and potential areas for growth, such as the integration of hybrid thoracoscopies (flexible-semi-rigid-rigid). We present a straightforward and effective approach using vascular sheaths and rigid optical forceps, paired with disposable flexible scopes, to create various configurations tailored to patient needs. These configurations range from standard flexible pleuroscopy to semi-rigid and fully rigid pleuroscopy, offering versatility in procedure options. By combining semi-rigid and rigid models, we aim to highlight the strengths of each modality, optimizing tissue acquisition, enhancing maneuverability, and prioritizing patient comfort. Furthermore, we explore the potential for resource-limited institutions to adopt this approach without the need for substantial capital investment. Ultimately, our goal is to identify alternative methods and techniques that can increase access to affordable pleuroscopy while minimizing financial barriers. Looking ahead, we anticipate the rapid evolution of high-quality thoracoscopic instruments that seamlessly integrate the best features of traditional scopes, while prioritizing more minimally invasive approaches.