Thoracoscopy
Thoracoscopy, also known as video-assisted thoracoscopy, is a procedure performed to inspect and treat lung problems. The thoracoscope consists of a thin tube attached to a miniature camera, which is inserted into the chest cavity through small incisions. The camera sends images to a television monitor, which helps your surgeon to clearly visualise the chest cavity and perform the procedure.
Indications:
Thoracoscopy is performed for both diagnostic as well as therapeutic purposes, and is indicated for the following:
- Detect abnormalities in the lungs, pleura (membrane covering the lungs), mediastinum (area between the two lungs) or pericardium (sac that encloses the heart)
- Biopsy (removal of tissue or fluid samples) from the lungs, pleura or mediastinum to examine for infections, cancer and other conditions
- Remove excess fluid or cysts from the pleural cavity
- Remove a section of diseased lung tissue
- Perform minimally invasive surgeries such as pericardiectomy (removal of a portion or all of the pericardium)
Procedure
Thoracoscopy is performed under general anaesthesia (where you are put to sleep). Your surgeon makes 3 to 4 small incisions in your side near the ribs and inserts the thoracoscope through one of the incisions. Your surgeon examines the lung and pleura and inserts surgical instruments through the other incisions to diagnose or treat the condition. On completion of the procedure, tubes may be placed in the chest cavity to drain fluid and/or air. The incision in the chest wall is then closed using stitches or staples.
Risks and complications
Complications resulting from a thoracoscopy can be serious but occur rarely. Some of these include:
- Pain, numbness and infection at the incision site
- Excessive bleeding
- Tears in the pleura causing air leakage
- Pneumonia (lung infection)
- Empyema (pus in pleura)
- Recurrent pneumothorax (collapsed lung due to leakage of air into pleura)
- Pulmonary oedema (fluid accumulation in the lungs)
Post-operative care and recovery
Following the surgery, you are required to stay in the hospital for 3 to 5 days depending on the procedure that is performed. Pain relieving medicines are given to keep you comfortable. You are taught breathing exercises to prevent infection and inflammation, and encouraged to walk shortly following the surgery to prevent blood clots and improve healing. After discharge, you are advised against driving for a week, lifting heavy weights and other strenuous activities. You are encouraged to continue your breathing exercises even after going home.
You should call your surgeon immediately in case you develop the following symptoms after thoracoscopy:
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