When your doctor says you have a problem with your chest, one way to find out exactly what it is and what's going on inside is called a thoracoscopy. You've probably heard this term before. Let's take a look at what it is, how it's done, and whether there's anything to be afraid of.
What is Thoracoscopy?
Simply put, a thoracoscopy is a small test that looks at the surface of your lungs and the space around them (called the pleural space). Doctors use a thin, lighted camera called a thoracoscope to look at your lungs. This can look at your diaphragm, esophagus, chest wall, and lymph nodes. Sometimes, a small piece of tissue (called a biopsy) may be taken from the area you want to examine.
Often, this thoracoscopy is performed as part of a video-assisted thoracoscopic surgery (VATS) . This allows the surgeons in the operating room to see what's inside the chest clearly on a large video screen. It's like putting a camera through a small hole and looking inside.
What are the types of thoracoscopy?
Now look, this thoracoscopy is used in a different way.
- Diagnostic Thoracoscopy: Sometimes your doctor will use this to see if there is a problem inside your chest, or to take a small piece of tissue (biopsy) for testing. This is sometimes called a pleuroscopy .
- Therapeutic Thoracoscopy: At other times, this method is used to treat a disease, that is, to perform surgery. This is what is used in the previously mentioned minimally invasive surgical method called `VATS` or `Video-Assisted Thoracoscopic Surgery`.
When is Thoracoscopy used?
Well, then, in what cases does a doctor decide to perform a thoracoscopy or VATS surgery?
- When you need to know the exact information that your chest X-ray, CT scan, or ultrasound couldn't find.
- When you need to remove a portion of the inner layer of the chest wall, called the pleura.
- Remove damaged parts of the lungs (this is called `lung volume reduction surgery`).
- Remove air pockets in the lungs.
- Remove a cancerous part of the lung (this is called a `lung resection`).
- Remove unnecessary fluid that has accumulated in the pleural space around the lungs and use medication to stop the fluid from accumulating again (this is called pleurodesis).
This test/surgery may be done, especially if you have lung cancer or mesothelioma. It can also be used to treat thymus gland cancer and esophageal cancer.
Difference between Thoracoscopy and Thoracotomy
Now you might be wondering, there's also a procedure called a thoracotomy, and what's the difference between that and a thoracoscopy. A thoracotomy is a surgery that involves making a large incision in the chest. But a thoracoscopy is a much less invasive procedure.
The advantages of this thoracoscopy method are:
- You can recover quickly.
- The pain is less.
- Complications after surgery are few.
However, sometimes, if the exact procedure cannot be done safely with a thoracoscopy, the doctor may have to perform a thoracotomy.
Who performs a thoracoscopy?
This thoracoscopy, or pleuroscopy, can be performed by your pulmonologist . However, the procedure called Video-Assisted Thoracoscopy Surgery (VATS) must be performed by a thoracic surgeon .
How should I prepare for a thoracoscopy?
There is also a way you need to prepare before this test/surgery.
- A few days before surgery, your doctor will tell you to stop taking certain medications (such as aspirin) that prevent blood from clotting easily, meaning they increase bleeding .
- You may also be asked to refrain from eating or drinking on the day of surgery.
How long does a Thoracoscopic Surgery take?
The time required for this thoracoscopic surgery can vary. It can usually take anywhere from half an hour to several hours . If something more complex than just taking a tissue sample is needed, it will take longer.
What happens during a thoracoscopy?
Okay, now let's see what happens during this surgery. You're having a `Video-Assisted Thoracoscopy Surgery (VATS)`, and you're under general anesthesia . That means you don't feel anything, you're asleep. Very rarely, this is done with just a little `sedation`.
The surgeon follows these steps:
1. You will be given an anesthetic through a saline solution given into a vein (an ``IV'').
2. A tube is placed down your throat and a machine controls your breathing (this temporarily shrinks one of your lungs, making the surgery easier).
3. Two or three small incisions, less than half an inch apart, will be made in your chest, near the seventh, sixth, and fourth ribs.
4. Through a single incision, the thoracoscope camera is inserted into the pleural space around the lungs.
5. Other small instruments needed for the surgery are inserted through the other incisions.
6. Samples are taken from areas that appear abnormal, or necessary surgery is performed.
7. Then take out the camera and all other equipment.
8. A chest tube is inserted into your chest to remove air from your lungs and restore the collapsed lung to normal.
9. Stitching up cuts.
10. You are woken up again and made to breathe on your own.
What can you expect after a thoracoscopy?
After the surgery, it will take some time for you to recover from the anesthesia. Your throat and mouth may feel numb for a while. You will not be allowed to eat or drink until the numbness wears off. Because of the breathing tube, your voice may be a little hoarse and your throat may be sore the day after the surgery. You may also have some pain where the incisions were made.
Don't be afraid, the doctor will give you the necessary medicine for this pain.
If you have had tissue samples (biopsies) taken from you, or fluid removed from around your lungs, you will have a chest tube in your chest for a day or two. You will also have a chest X-ray to make sure there are no problems with your lungs.
Most of the time, after these types of thoracoscopic surgeries, you have to stay in the hospital while the chest tubes are in place. But sometimes, if nothing major is done, you can go home after a few hours of rest. If you do, you should have a friend or relative take you home.
Is Thoracoscopy painful?
This is a problem that many people have. You will not feel any pain during a thoracoscopy because you are anesthetized. After the surgery, you can take painkillers to help with the pain in the incisions.
How long does it take to recover from a thoracoscopy?
It takes about two weeks to resume normal activities after this surgery. It usually takes about four to six weeks to fully recover.
Is Thoracoscopy dangerous?
As with any medical procedure, there is a small risk. The mortality rate for medical thoracoscopy is estimated to be very low, at 0.3%. For video-assisted thoracoscopy, the rate is slightly higher. However, the complication rate for both procedures is between 2% and 11% . This includes both minor and serious complications.
What are the risks of a thoracoscopy?
What are the possible complications of a thoracoscopy?
- Bleeding.
- Infections in the lungs or cuts.
- Fever.
- Air accumulation in the pleural space or near the incision.
- Collapsed lung.
- Fluid accumulation around the lungs.
What are the results? What does it say?
After the surgery, the doctor will tell you whether the problem you had was corrected or not. Also, after the lab results come in, they will tell you whether the tissue removed is cancerous or benign. If you have cancer, you will also be able to find out where it is in the cancer staging system .
It can take several days for the hospital laboratory to test the tissue samples and provide reports.
When should I call the doctor?
When you go home after surgery, you should call your doctor immediately if you experience any of these symptoms:
- Difficulty breathing.
- Fever.
- Chest pain.
- New swelling in the chest or neck.
The most important things you need to keep in mind
Imagine how amazing it is to be able to see and sometimes treat problems inside your chest through just a few small incisions with this procedure called a thoracoscopy. If you are unsure about something or have any doubts, don't hesitate to ask your doctor. If you have a good understanding of this test/surgery, your fear will be greatly reduced. It is also very important to follow the instructions given before the surgery and to follow the instructions given by your doctor during the recovery period after the surgery.
` Thoracoscopy, lung surgery, VATS, pleuroscopy, chest examinations, minimally invasive surgery, respiratory diseases
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