Thoracoscopy

Thoracoscopy is a minimally invasive procedure that allows surgeons to examine the pleural lining of the lungs and the surface of the lungs. Internal images and video obtained from this technique help doctors identify signs of pleural mesothelioma such as inflammation, pleural plaques, and pleural thickening.

During a thoracoscopy, a sterilized flexible tube containing a small fiber-optic camera called an endoscope is used to investigate the chest. This allows the surgeon to view your lungs on a video monitor.

However, visual signs of disease are not enough to confirm a mesothelioma diagnosis with certainty. During this procedure, doctors can also perform a biopsy, a much more reliable technique for diagnosis.

While viewing the pleural space through the camera feed, surgeons insert tools through channels in an endoscope that can collect multiple tissue samples. Pathologists can then see these samples under a microscope to rule out other chest cancers and make a mesothelioma diagnosis.

Your doctor may also use the word pleuroscopy to describe this procedure. If surgeons use thoracoscopy to assist with minor surgery, the procedure is often called video-assisted thoracoscopic surgery, or VATS.

Recovery from a Thoracoscopy

After the procedure, the chest tube must remain in place for at least two to three days, or until your lung fully expands without any leaks.

To help relieve pain, doctors will provide medicine orally, through an IV and the chest tube. To prevent pneumonia, nurses and respiratory specialists will encourage you to perform coughing and breathing exercises.

Contact your doctor immediately if you experience any of the following:

  • Chest pain
  • Increased shortness of breath or difficulty breathing
  • Fever exceeding 100.5 F
  • Increased redness, drainage or swelling near incisions or chest tube
  • Foul-smelling drainage from incisions
  • A bubbling or sucking sound from an incision

One to two weeks after surgery, you will return to the hospital for a follow-up with your doctor.

Risks and Complications

Few risks are associated with a thoracoscopy, and it is substantially less risky than a thoracotomy — a much more invasive open chest surgery also used to diagnose mesothelioma.

Although a thoracoscopy is a safe procedure, there are some potential risks.

Complications may include:

  • Wound infection
  • Severe bleeding
  • Pain or numbness around incisions
  • Lung inflammation (pneumonia)
  • Air leakage through the lung wall
  • Adverse reaction to anesthesia

 

Initially, researchers voiced concerns about tumor seeding after thoracoscopy. This rare complication involves unintentional tumor spread as doctors pull cancerous cells into unaffected areas while manipulating the camera.

One study from 1995 determined that radiation therapy could be used to prevent tumor seeding. Out of 20 patients who received a total of 38 thoracoscopies, preventative radiation therapy resulted in zero instances of tumor seeding.