Medical Thoracoscopy-assisted Thoracographic Fibrin Glue Sealing Method for Intractable Pneumothorax: A Case-based Proposal

We herein report a case of refractory pneumothorax in a patient with interstitial lung disease that was successfully treated using medical thoracoscopy-assisted thoracographic fibrin glue sealing (MTS-TGF). This novel hybrid technique enables accurate leak localization and safe delivery of fibrin glue under direct visualization and fluoroscopic guidance. The procedure achieved substantial leak reduction followed by complete resolution without surgical intervention. MTS-TGF may enhance the precision and safety of conventional TGF, particularly in anatomically complex or high-risk patients. This case supports MTS-TGF as a promising minimally invasive option for persistent air leaks when surgery is contraindicated.