Thoracoscopy

Thoracoscopy is a procedure in which a thin, lighted tube (thoracoscope) is put through a small cut (incision) in the chest wall. This procedure makes it possible for your caregiver to look at the lungs or other structures in the chest cavity and to do some minor operations. This is a more minor procedure than thoracotomy, which opens the chest cavity with a large incision. Thoracoscopy can sometimes be used instead of thoracotomy. Thoracoscopy usually involves less pain, a shorter hospital stay, and a shorter recovery time.

Common reasons for this procedure are:

  • To study diseases or problems in the chest.

  • To take a tissue sample (biopsy) to study under a microscope.

  • To put medicines directly into the lungs.

  • To remove collections of fluid, pus (empyema), or blood in the chest.

LET YOUR CAREGIVER KNOW ABOUT:

  • Allergies to food or medicine.

  • Medicines taken, including vitamins, herbs, eyedrops, over-the-counter medicines, and creams.

  • Use of steroids (by mouth or creams).

  • Previous problems with anesthetics or numbing medicines.

  • History of bleeding problems or blood clots.

  • Previous surgery.

  • Any history of heart problems.

  • Other health problems, including diabetes and kidney problems.

  • Possibility of pregnancy, if this applies.

RISKS AND COMPLICATIONS

  • If too much bleeding occurs, or if the surgery turns out to be major, it may be necessary to open the chest (thoracotomy) to control the bleeding.

  • There is a risk of injury to nerves or other structures in the chest as a result of the placement of the instruments.

  • When the chest tube is removed, the lung may collapse (pneumothorax). If this happens, the tube may need to be reinserted and left in place until a time when the lung will remain expanded as the tube is removed.

BEFORE THE PROCEDURE

  • You may have routine tests done, such as blood tests, urine tests, and chest X-rays.

  • Electrocardiography (EKG) to record the electrical activity of the heart may be done to make sure the heart is okay.

  • Do not eat or drink after midnight the night before the procedure. Medicine given before the procedure that makes you sleep (general anesthetic) may cause vomiting. A patient who vomits is in danger of inhaling food into the lungs. This can cause serious complications and can be life-threatening.

PROCEDURE

Video-assisted thoracic surgery (VATS) is surgery using a thoracoscope with a small video camera on the end. The picture from inside the chest is displayed on a television screen for the surgeon to see. The lung being worked on is collapsed and several small incisions are made to insert instruments. The surgeon can manipulate the instruments while watching on the television screen. The thoracoscope may be removed and put into different areas as needed. When the procedure is finished, the surgeon expands the lung and puts one or more chest tubes in the chest. The chest tubes allow the lung to expand and allow fluid (drainage) to come out. The remaining incisions are closed with stitches (sutures) or staples.

AFTER THE PROCEDURE

  • The chest tube is left in place for 1 to several days to drain fluid or air from the chest cavity.

  • Hospital stays range from 1 to 5 days depending on the procedure and treatment.