Thoracoscopy

Thoracoscopy is a medical procedure involving internal examination, biopsy, and/or resection of disease or masses within the pleural cavity and thoracic cavity. Thoracoscopy uses a thin, flexible viewing tube (called a thoracoscope) to visually inspect the lungs, mediastinum (the area between the lungs), and the pleura (the membrane covering the lungs and lining the chest cavity).

The purpose of Thoracoscopy is:

• To visually inspect the lungs, pleura, or mediastinum for evidence of abnormalities
• To obtain tissue biopsies or fluid samples from the lungs, pleura, or mediastinum in order to diagnose infections, cancer, or other diseases
• Used therapeutically to remove excess fluid in the pleural cavity or pleural cysts or to remove a portion of diseased tissue (wedge resection)
• To evaluate patients with pulmonary disease or abnormalities of the sac that surround the heart or the lining of the chest
• As a minimally-invasive method to perform certain types of surgery, such as pericardiectomy

BEFORE THE PROCEDURE

Tell your doctor if you regularly take anticoagulants, nonsteroidal anti-inflammatory drugs (such as aspirin, ibuprofen, or naproxen) or any other medications. You may have to discontinue certain drugs before the test. Do not eat or drink anything at least 12 hours before the surgery.

DURING THE PROCEDURE

Right before the surgery, an IV or catheter is inserted into a vein in your arm and you are placed under anesthesia. A thin tube is then inserted through your mouth and into your lungs. The lung on the operative side is partially or completely deflated to create space between the lung and chest wall and provide the surgeon a clear view of the area.

The surgeon will make several small incisions in your chest and insert drainage tubes to remove blood during the procedure. The scope is passed into the space between the lung and the chest wall and images of the area can be seen on a TV screen in the operating room.

After inspection of the lung and pleura, the doctor may insert surgical instruments through small incisions to remove tissue or fluid for diagnostic examination or as a therapeutic measure.

Finally, the collapsed lung is re-expanded and the incisions are closed with stitches or adhesive tape. A thin tube is placed in the remaining incision and left there for one to two days to drain fluid from the chest.

AFTER THE PROCEDURE

Depending on the suspected problem, tissue and fluid may be sent to different labs. If a definite diagnosis can be made, appropriate treatment will be initiated by your doctor. If your doctor cannot make a diagnosis, additional tests may be needed.