Thoracoscopy

A thoracoscopy is done to examine the space between the lungs and the walls of the chest (pleural cavity). It is also used to do specialized procedures in the chest (thoracic) cavity. It is done using a thoracoscope, which is a type of endoscope with a small video camera on the end.

A thoracoscopy may also be called pleuroscopy. It may be called video-assisted thoracic surgery (VATS) when the live video is displayed on a monitor in the operating room.

A thoracoscopy is done to:

• look closely at an abnormal area that was seen on a chest x-ray or CT scan
• diagnose and stage cancers in the chest cavity, such as lung cancer, mesothelioma and esophageal cancer
• diagnose and treat other diseases in the chest

A thoracoscopy can be used to examine and get tissue samples from the:

• linings of the lungs (parietal and visceral pleura)
• pleural cavity
• chest wall
• space between the lungs (mediastinum)
• membrane that surrounds the heart (pericardium)

Doctors can also use a thoracoscopy to:

• remove small lung tumours
• drain fluid or pus from the pleura or lung
• put medicines or other treatments directly into the lung (pleurodesis)

A thoracoscopy is done as an in-patient procedure in a hospital. You will be under general anesthesia, which means you will be asleep during the procedure. You will need to stay in the hospital until your healthcare team thinks you are ready to go home. In some cases, you may be able to go home on the same day.

Your healthcare team will tell you how to prepare for a thoracoscopy. You may be told to not eat or drink anything for 6 to 12 hours before the procedure.

Tell your healthcare team about all prescription and non-prescription medicines you are taking. You may need to stop taking certain medicines that increase the risk of bleeding, including blood thinners (anticoagulants).

If you have a fever, persistent cough or any heart problems, talk to your healthcare team to figure out the best timing for the procedure.

To do a thoracoscopy, your doctor will make 1 to 3 small cuts (incisions) on the side of the chest between 2 ribs and through the chest wall. Your doctor will pass the thoracoscope into the chest cavity through one of the incisions. They will pass surgical instruments into the chest through the other incisions.​

​If you need a thoracoscopy to examine a diseased lung, the doctor may deflate that lung or put air into the space around the lung to make it smaller. This gives the doctor more room to look around in the chest cavity so that it is easier to notice any abnormalities on or around the lung.

Your doctor will take samples of fluid or tissue from any areas that look abnormal so they can be looked at more closely.

When the procedure is finished, the doctor will remove the thoracoscope. The incisions will be closed and covered with bandages. A chest tube may be placed in one of the incisions to help drain fluid and air, which will allow your lung to re-inflate.

Your healthcare team will closely monitor you until they think it is safe for you to leave the hospital. You can usually go home once the chest tube is removed (if you have one).

Your mouth and throat may feel dry and sore for a few hours after the procedure. You may also feel drowsy from the anesthetic and other medicines that you received.

Your healthcare team will tell you if there is anything you can't eat or do for a while after a thoracoscopy. Contact your healthcare team as soon as possible if you notice any unusual symptoms after you get home, such as coughing up blood.

The tissue samples collected during a thoracoscopy will be tested in a lab. The lab report is usually ready within a few days. It is important to note that the results could mean different things. Your doctor is the best person to explain them to you.

Side effects can happen with any procedure. Some common side effects from a thoracoscopy are pain at the incision site and shortness of breath.

Other side effects are rare but may include:

• bleeding
• wound infection
• collapsed lung
• air from the chest cavity getting into the tissues under the skin of the chest, neck or face (subcutaneous emphysema)

Your doctor will decide if you need further tests, procedures, follow-up care or more treatment.

Preparing children for a test or procedure by explaining what will happen during the test, such as what the child will see, feel and hear, can be very helpful. Preparing children before a test or procedure can help lower their anxiety, make them more cooperative and develop their coping skills.

How you prepare your child for a thoracoscopy depends on your child's age and experience. Find out more about helping your child cope with tests and treatments.