A thoracoscopy is a medical technique that allows a clinician to examine the area inside the chest (outside of the lungs). A thoracoscope is a thin, flexible tube with a light and a small video camera on the end that is used to perform this. The tube is inserted through a tiny incision made between the ribs towards the bottom end of the shoulder blade. Thoracoscopy is occasionally used as part of a VATS operation.

What is the purpose of a thoracoscopy?

Thoracoscopy may be required for a variety of reasons:

To figure out why you're having lung issues.

To determine the source of lung issues (such as trouble breathing or coughing up blood).

To examine suspicious region in the chest.

Thoracoscopy can be performed to examine a suspicious region shown by an imaging test (such as a chest x-ray or CT scan). It can also be used to get biopsy samples from lymph nodes, aberrant lung tissue, the chest wall, or the lung lining (pleura). It is frequently prescribed to patients who have mesothelioma or lung cancer.

For the treatment of minor lung tumors

Small lung cancers can occasionally be treated using thoracoscopy by removing just the tumor-bearing portion of the lung (wedge resection) or the entire lobe of the lung (lobectomy) if the tumor is bigger. It may also be used to treat malignancies of the esophagus or thymus gland in some circumstances.

For draining extra fluid from lungs

Thoracoscopy is used to drain extra fluid from around the lung that is causing breathing problems. This fluid can also be submitted to a lab for cancer or infection testing. If the fluid surrounding the lungs is evacuated but returns, a thoracoscope can be used to inject medication into the chest cavity to prevent the fluid from returning (pleurodesis).

Prior to the examination

Make sure your doctor is aware of any medications you're taking, including vitamins, herbs, and supplements, as well as any drug allergies you may have.

Before the test, you may be advised to cease taking blood-thinning medications (including aspirin) for a few days. You may also be urged to refrain from eating or drinking for several hours before the operation. You will be given precise instructions by your doctor or nurse.

Taking the exam

Depending on what is being done, a thoracoscopy can be an outpatient (you don't have to remain in the hospital overnight) or an inpatient (you have to stay in the hospital overnight or for a few days) treatments. If the procedure is performed as an outpatient, you may just require local (rather than general) anesthesia and light sedation.

The outpatient technique is identical to the inpatient (VATS) operation generally performed in the operating room, as detailed below. You will be given medications through an intravenous (IV) line to put you in a deep slumber for this test (under general anesthesia). During the surgery, a tube will be inserted into your neck and connected to a breathing machine. The thoracoscope is introduced through a tiny incision in the back, right below the point of the shoulder blade, between two ribs. On the same side, a tiny slit is made just below the underarm to allow the device containing the cutting tool to be inserted. Some of the air in that side's lung may be released, making it easier to breathe.

Then, using the cutting tool, any aberrant regions are excised or biopsied, and the results are verified in the lab.

If fluid has to be evacuated, a third puncture in the lower chest wall is made, and a flexible catheter (also known as a chest tube) is inserted to allow fluid to drain over a few days. Following that, the thoracoscope and cutting instrument will be withdrawn, and the wounds will be closed. You will be softly awakened and removed from the breathing machine after the operation is completed.

Depending on what's being done, the operation might take anywhere from 30 to 90 minutes.

Following the examination,

You will be constantly monitored, after the examination to ensure that you have no complications. For a few hours after the anesthetic wears off, you may feel sluggish or disoriented. For a few hours, your mouth and throat will most likely be numb. You won't be able to eat or drink anything till the numbness has gone away. You could experience a sore throat, cough, or hoarseness over the next day or so after the numbness goes away. In the areas where the incisions were done, you may experience discomfort or numbness.

If you had the procedure as an outpatient, you should be able to go home in a few hours, but you will almost certainly require transport home due to the medications or anesthetic you got.

Possible thoracoscopy complications

The following are some of the dangers associated with a thoracoscopy:

• Bleeding
• Pneumonia is an infection of the lungs (infection in the lung)
• Because the surgery could not be done with the smaller incision used by thoracoscopy, a thoracotomy was required, in which the chest cavity was opened with a bigger cut.
• Part of a lung has collapsed (pneumothorax)
• Infection of the wounds (cuts)
• After the thoracoscopy, your doctor will request a chest x-ray to check for pneumothorax (or other lung problems). Some issues may resolve on their own, but if they are producing symptoms (such as breathing difficulties), they may require treatment.