Medical thoracoscopy/pleuroscopy (MT/P), compared with surgical thoracoscopy (VATS), has the advantage that it can be performed under local anesthesia or conscious sedation, in an endoscopy suite, using nondisposable rigid (or semirigid) instruments. Thus, it is considerably less expensive. MT/P is a safe procedure which is even easier to learn than flexible bronchoscopy, provided that sufficient experience with chest-tube placement has been gained.