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Thoracoscopy (Pleuroscopy)

A thoracoscopy examines the chest (thoracic) cavity using an endoscopeendoscopeA thin, tube-like instrument with a light and lens used to examine or treat organs or structures in the body. (a thin, tube-like instrument with a light and lens). A thoracoscopy may also be used to perform specialized procedures in chest cavity. It may also be called pleuroscopy.

Why a thoracoscopy is done

A thoracoscopy is done to both diagnose and treat certain lung problems. It is done to:

  • examine the
    • linings of the lungs (parietal and visceral pleura)
    • pleural spaces
    • chest wall
    • mediastinum(the space in the chest between the lungs, breastbone and spine)
    • pericardium (the double-layered sac that surrounds the heart)
  • find out the reason for a buildup of fluid around the lungs (pleural effusionpleural effusionAn abnormal buildup of fluid in the pleural cavity (space between the lungs and the walls of the chest).)
  • diagnose and stage cancers within the chest cavity, such as lung cancer, mesothelioma or esophageal cancer
  • diagnose diseases within the chest when other methods do not provide enough information to make a diagnosis
  • biopsy the pleura, mediastinal lymph nodes and lung
  • do procedures, such as:
    • laser surgery (a surgical procedure that uses a laser to make bloodless cuts in tissue)
    • draining fluid or pus from the pleura or lung
    • putting medications or other treatments directly into the lung (pleurodesis)
    • removing small lung tumours
    • removing air-filled sacs in the lung (bullae) caused by chronic lung disease, such as emphysema

How a thoracoscopy is done
  • Special preparation is needed before the doctor can perform a thoracoscopy.
    • Do not eat or drink anything for at least 8 hours before the test.
  • A thoracoscopy is done in a hospital operating room while the person is under general anesthetic.
  • A thoracoscopy is done using 1–3 small cuts (incisions) made 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.
  • Video-assisted thoracoscopy (VAT) or video-assisted thoracic surgery (VATS) uses a thoracoscope with a small video camera attachment for surgical purposes.
  • If the thoracoscopy is being done to examine a diseased lung, that lung is generally deflated to make room for examination. Air may also be put into the space around the lung, which 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 can then be taken from suspicious areas. Surgical instruments can be put into the chest through the other small incisions (ports), which allows the doctor to remove small lung tumours with VATS.
  • 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.
  • There will be some discomfort or numbness at the incision sites after the procedure.
  • The person may be in hospital for 1–4 days after the procedure. If they have a chest tube, they can usually go home once the chest tube is removed.

Potential side effects

The risks from thoracoscopy are:

  • sore throat or trouble swallowing
  • bleeding
  • wound infection
  • pneumonia
  • breathing difficulties
  • pain or numbness
  • irregular heartbeat (cardiac arrhythmia)
  • partial or complete collapse of the lung (atelectasis)
  • buildup of air in the space between the lungs and the wall of the chest (pneumothorax) that causes the lung to partially or completely collapse
  • air from the chest cavity that gets into the tissues under the skin of the chest, neck or face (subcutaneous emphysema)
  • tear (puncture) of the lung

What the results mean

A thoracoscopy can show:

  • collection of pus in the pleural space (empyema)
  • abnormal or enlarged lymph nodes within the chest
  • lung diseases such as tuberculosis and emphysema
  • cancer, such as lung cancer or pleural mesothelioma
  • collection of fluid in the pleural space from a disease process

What happens if a change or abnormality is found

The doctor will decide whether further tests, procedures, follow-up care or additional treatment is needed.


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