Disposable peel-away sheaths for pleural space access: a minimally invasive conduit for medical thoracoscopy and chest tube insertion.

The global rise in lung diseases has renewed interest in thoracoscopy, underscoring its growing role in modern clinical practice. As this field evolves, the need for practical, adaptable, and cost-effective tools becomes increasingly important. This report explores the use of peel-away sheaths to access the pleural space during medical thoracoscopy, serving as conduits for both flexible and rigid instruments. Their use enables precise placement of small-bore or surgical chest tubes in targeted anatomical locations and allows for the selection of sheath sizes based on procedural needs. Between April 2024 and February 2025, an observational study was conducted at Los Angeles General Medical Center, a tertiary care hospital, involving 45 consecutive patients undergoing medical thoracoscopy using peel-away sheaths. The results demonstrated a strong safety profile. There were no major complications, fatalities, or instances of bleeding, lung injury, or insertion site infections. Patients experienced minimal discomfort and favorable perioperative pain scores. The technique proved versatile, functioning effectively across a range of anatomical sites and levels of procedural complexity. It was also successfully implemented in diverse clinical environments, including outpatient endoscopy suites and inpatient step-down units. These findings highlight the practicality, safety, and adaptability of peel-away sheaths in thoracoscopic procedures. Their ease of use, compatibility with various instruments, and low cost make them especially valuable in resource-conscious settings. By offering procedural flexibility and improving access to the pleural space, this approach may support broader adoption of medical thoracoscopy and enhance patient care across a variety of healthcare settings.