DIAGNOSTIC THORACOSCOPY
 

A medical thoracoscopy is a minimally invasive surgical technique used to diagnose and treat problems in your chest.

During this procedure, a tiny camera (thoracoscope) and surgical instruments are inserted into your chest through one or more small incisions in your chest wall. The thoracoscope transmits images of the inside of your chest onto a video monitor, guiding the surgeon in performing the procedure.

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INDICATIONS FOR THORASCOPY

A thoracoscopy is done to diagnose and stage cancers within the chest cavity, such as lung cancer, mesothelioma and esophageal cancer. It can be used to examine and get tissue samples from the:

  • linings of the lungs (parietal and visceral pleura)

  • pleural spaces

  • chest wall

  • space in the chest between the lungs (mediastinum)

  • membrane that surrounds the heart (pericardium)

 

Some procedures can be done in the chest cavity during a thoracoscopy:

  • remove small lung tumors

  • drain fluid or pus from the pleura or lung

  • put medicines or other treatments directly into the lung (pleurodesis)

 

A thoracoscopy may also be used to diagnose and treat other diseases of the chest, not just cancer.

 

THE PROCEDURE

A thoracoscopy is done in a hospital operating room under general anesthetic, which means you will be asleep during the procedure. You may be in hospital for 1 to 4 days after a thoracoscopy.

Your healthcare team will tell you how to prepare for a thoracoscopy. You may be told to not eat or drink anything for 6 to 12 hours before the test. Tell your healthcare team about all prescription and non-prescription medicines you are taking.

A thoracoscopy is done by making 1 to 3 small cuts (incisions) on the side of the chest between 2 ribs and through the chest wall. A thoracoscope is inserted through one of the incisions into the chest cavity. If you are having VATS to remove small lung tumors, the other incisions are used to put surgical instruments into the chest.

If the thoracoscopy is being done to examine a diseased lung, that lung may be deflated so that the doctor has more room to look around in the chest cavity. Air may also be put into the space around the lung. This makes the lung smaller so that the doctor can see more of the structures on and around the lung.

Samples of fluid, cells or tissue are taken from areas that look abnormal so they can be looked at under a microscope. The thoracoscope is then removed and the incisions are covered with small bandages. A chest tube may be inserted into one incision to help drain fluid and air. You can go home once the lung is working properly and the chest tube is removed.

POTENTIAL COMPLICATIONS

Side effects can happen with any procedure. The most common side effect from a thoracoscopy is a fever. Other side effects are rare but may include:

  • wound infection

  • lung infection (pneumonia)

  • trouble breathing

  • pain or numbness

  • collapsed lung

  • air from the chest cavity getting into the tissues under the skin of the chest, neck or face (subcutaneous emphysema)

  • puncture of the lung

FOLLOW-UP

There will usually be a short hospital stay for monitoring after the procedure.  After you are discharged, an appointment will be made for a week or two after if samples were taken so that the samples can be analyzed.