Modern-day thoracoscopy involves passage of a semirigid pleuroscope through the chest wall via a single trocar, and offers the clinician direct visualization for the collection of samples from the pleura, lung surface, and potentially the pericardium.8The single trocar technique as a means of minimally invasive thoracoscopic surgery in the diagnosis and treatment of noncomplex pleural disease is becoming increasingly popular among surgeons as well as nonsurgeons who perform medical thoracoscopy.9It is a valuable diagnostic procedure and can potentially provide an opportunity for treatment such as pleurodesis.10Although the semirigid scope facilitates the visualization of the pleural space, the scope must be removed and a chest tube placed blindly once the procedure is completed.11–15 It is often difficult to accurately place a chest tube in a particular place without direct visualization, and blind chest tube placement has been associated with significant morbidity and mortality.16 Thoracic surgeons are often able to visualize their chest tubes at the end of video-assisted thoracoscopy, as they often have two or more working ports. Creating a second thoracic entry portal through which a chest tube can be placed during medical thoracoscopy while viewing its placement under pleuroscopic guidance is reasonably intuitive; however, this increases procedure time and the associated risks, including increased postprocedure pain, damage to surrounding structures, and a potential second portal of infection.4,17–18 Accurate placement of a chest tube through the same entry portal used for thoracoscopy would be ideal and can be facilitated by using a rigid telescope. The reason to use the rigid scope alone is that it allows for exact placement of the necessary chest tube(s) without increasing the morbidity of the procedure. The pleuroscope cannot be used for this purpose because of its larger diameter and potential for damage to the distal “flexible” portion of the scope when placed or removed from within the chest tube. Of note, the “rigid” telescope can be easily damaged or bent, and care should be taken so as not to use the rigid telescope to leverage the chest tube(s) into place. Direct visual placement can be accomplished in most cases without the need to leverage against the ribs to facilitate the desired placement of the chest tubes.