A thoracoscopy is a procedure to examine the chest cavity. It is done using a thoracoscope, which is a type of endoscope. Video-assisted thoracic surgery (VATS) uses a thoracoscope with a small video camera attached to it.
A thoracoscopy may also be called pleuroscopy.
Why a thoracoscopy is done
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 tumours
- 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.
How a thoracoscopy is done
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 tumours, 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 side effects
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
What the results mean
An abnormal result may mean:
- there is cancer in the lung, in the lining that protects your lungs (called the mesothelium) or in the esophagus
- cancer has spread to the lymph nodes or the chest wall
- cancer has spread to the lungs from other parts of the body
- pleural effusion
What happens if a change or abnormality is found
The doctor will decide whether you need further tests, procedures, follow-up care or more treatment.
Special considerations for children
Being prepared for a test or procedure can reduce anxiety, increase cooperation and help the child develop coping skills. Parents and caregivers can help prepare children by explaining to them what will happen, including what they will see, feel, hear, smell and taste during the test.
Preparing a child for a thoracoscopy depends on the age and experience of the child. Find out more about helping your child cope with tests and treatments.
A thin, tube-like instrument with a light and lens used to examine or treat organs or structures in the body.
An endoscope can be flexible or rigid. It may have a tool to remove tissue for examination. Specialized endoscopes may have tools designed to examine or treat specific organs or structures in the body.
Specialized endoscopes are named for the organ or structure they are used to examine or treat.
The area of the body between the neck and the abdomen. It includes the rib cage, muscles and tissues that move during breathing.
The chest wall protects the lungs, heart and liver.