Internal thoracoscopy has a wide range of uses, both for diagnosis and treatment of diseases. First of all, cancerous pleural effusion is the main diagnostic and therapeutic indication for endoscopy, and it can be said that the diagnostic rate of endoscopy for any type of malignant pleural effusion is very high. For example, in metastatic malignant pleural effusion, the diagnostic rate using blind examination of the mural pleura is low, and the mural pleura is often not examined in about 30% of patients. In contrast, biopsy of lesions on the dirty and mural pleura can be directly seen under thoracoscopy to confirm the diagnosis. Pleural fixation can be performed simultaneously with medical thoracoscopy to control the regrowth of malignant pleural effusions. Secondly, the diagnosis and treatment of tuberculous pleural effusion can be confirmed by almost 100%, and the patient can be relieved of the pain by clearing the adhesions, eliminating the wrapped cavity, removing the effusion and necrotic tissue, and restoring the lung function during the operation of tuberculous pleurisy with chronic tendency such as extensive formation of pleural adhesions and compartment. Third, internal thoracoscopy is more effective for patients with abscess chest, and thoracoscopic treatment can rapidly reduce fever and alleviate symptoms. Fourth, thoracoscopy can be used for the diagnosis and treatment of refractory pneumothorax. For patients with spontaneous pneumothorax with poor effect of ordinary drainage, repeated multiple pneumothorax or combined liquid pneumothorax or hemopneumothorax, thoracoscopy needs to be performed as soon as possible, which can help to understand the size of large alveoli under the dirty pleura, bronchopleural fistula and lung rupture opening and provide a basis for the next treatment. Currently, thoracoscopy includes medical thoracoscopy and surgical thoracoscopy, with the following main differences: First, medical thoracoscopy is performed by a pulmonologist or respiratory endoscopist in the endoscopy room, while surgical thoracoscopy is mainly television-assisted thoracoscopic surgery (VATS), which is performed by a thoracic surgeon in the operating room. Second, medical thoracoscopy is done with local anesthesia (or with the addition of intravenous sedation) and is easily tolerated by patients, whereas surgical thoracoscopy requires general anesthesia and double-lumen tracheal intubation to ensure operation on the affected side. Third, medical thoracoscopy rarely uses disposable supplies, does not require general anesthesia, and is significantly less expensive than surgical thoracoscopy. Fourth, because of the small field of view, medical thoracoscopy is mainly used for diagnosis, adhesion release and pleural fixation, while surgical thoracoscopy can complete operations such as lesion removal and pleural release for severe adhesions.