What is a thoracoscopy?

A thoracoscopy is a procedure to look for any problems in your pleural space, using a telescope. The pleural space is the space between the outside lining of your lungs and the inside lining of your ribcage.

What are the benefits of a thoracoscopy?

Your doctor is concerned that you may have a problem in your lungs or your chest. A thoracoscopy is a good way of finding out if there is a problem.

During the procedure, your doctor can perform biopsies (removing small pieces of tissue) to help make the diagnosis.

A pleurodesis can be performed at the same time to treat a pleural effusion (where there is too much fluid in your pleural space) or a pneumothorax (where air escapes into your pleural space) that may cause your lung to collapse. A pleurodesis involves sticking your lung to your ribcage.

Are there any alternatives to a thoracoscopy?

An x-ray or scan can give some information. Sometimes a biopsy can be performed by inserting a needle through your chest or airway.

What will happen if I decide not to have a thoracoscopy?

Your doctor may not be able to confirm what the problem is.

What does the procedure involve?

A thoracoscopy is sometimes performed under a general anaesthetic.

A thoracoscopy usually takes about 45 minutes. It involves making a hole in your chest wall and then inserting a telescope into the hole.

Your doctor will inject local anaesthetic into the area where they will make the hole. They will use an instrument called an introducer to insert the telescope in the hole.

Your doctor will look carefully for problems and perform any biopsies.

Your doctor will insert a tube in the hole (chest drain) to release any air or fluid that can sometimes collect.

What complications can happen?

The healthcare team will try to reduce the risk of complications.

Any numbers which relate to risk are from studies of people who have had this operation. Your doctor may be able to tell you if the risk of a complication is higher or lower for you. Some risks are higher if you are older, obese, you are a smoker or have other health problems. These health problems include diabetes, heart disease or lung disease.

Some complications can be serious and may even cause death.

• Pneumothorax — if a lot of air escapes, you will need to stay in hospital for 1 to 2 days. Sometimes a leak continues.
• Shortness of breath.
• Bleeding from the area where the hole is made or from a biopsy site.
• Infection in your pleural space. You will need to stay in hospital.
• Allergic reaction to the equipment, materials or medication.
• Pulmonary oedema, where your lung gets soggy with fluid, causing shortness of breath. You will need to stay in hospital for further treatment.
• Surgical emphysema, where air leaks into the tissues under your skin.
• Chest infection — your risk will be lower if you have stopped smoking and you are free of Covid-19 (coronavirus) symptoms for at least 7 weeks before the operation.

Consequences of this procedure

• Pain. This usually settles after about 20 minutes.

How soon will I recover?

If you have not had a pleurodesis, you should be able to go home after your doctor has removed the drain and you have recovered from the sedative.

You should be able to return to work after about 1 to 5 days unless you are told otherwise.

Regular exercise should improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

The healthcare team will tell you what was found during the thoracoscopy and discuss with you any treatment or follow-up you need.

Summary

A thoracoscopy is usually a safe and effective way of finding out if there is a problem in the space between your lungs and ribcage.

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