Thoracoscopy

What is Thoracoscopy

Thoracoscopy is a procedure to examine the lungs and other structures in a person’s chest. It involves the use of a thin, lighted telescope with an attached camera (thoracoscope).

Your health care provider inserts this instrument through a small surgical cut (incision) in your chest wall.

You may have thoracoscopy to:

  • Diagnose conditions in the lungs and chest area.
  • Obtain a tissue sample to be examined under a microscope (biopsy).
  • Have medicines put directly into your lungs.
  • Remove fluid, blood, or pus from your lungs.
  • Perform minor surgical repairs.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.
  • Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Bleeding. If this happens, your health care provider may need to open your chest with a large incision (thoracotomy) to control the bleeding.
  • Injury to nerves or other structures in your chest.
  • Collapsed lung. This can happen after the removal of the chest tube that is used for the procedure. The tube may need to be reinserted and left in place for a period of time.
  • Infection.
  • Heart rhythm abnormalities.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

  • Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

  • 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
  • 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
  • 6 hours before the procedure – stop drinking milk or drinks that contain milk.
  • 2 hours before the procedure – stop drinking clear liquids.

Medicines

Ask your health care provider about:

  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.

General instructions

  • Plan to have someone take you home from the hospital or clinic.
  • Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.
  • You may need to have tests prior to the procedure. These include:
    • Blood tests.
    • Urine tests.
    • Chest X-rays.
    • Electrocardiogram (ECG).
  • Ask your health care provider what steps will be taken to help prevent infection. These may include:
    • Removing hair at the surgery site.
    • Washing skin with a germ-killing soap.
    • Antibiotic medicine.

What happens during the procedure?

  • An IV will be inserted into one of your veins.
  • You will be given one or more of the following:
    • A medicine to help you relax (sedative).
    • A medicine to numb the area (local anesthetic).
    • A medicine to make you fall asleep (general anesthetic).
  • Your health care provider will make two or three small incisions on the side of the chest that is being examined.
  • Your health care provider will place the thoracoscope through one of the incisions and use it to look inside your chest. The camera will project the images from the scope to a monitor in the operating room.
  • Your health care provider will use the other incisions to insert surgical instruments to take a sample of lung tissue or fluid, or to do a minor repair.
  • A small drain will be placed in your chest to drain any blood or fluid that collects after surgery.
  • The scope and instruments will be removed.
  • The incisions will be closed with stitches (sutures).
  • A bandage (dressing) may be placed over the incisions.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.
  • You may be given medicine for pain as needed.
  • Your drain may be removed before you go home.
  • Do not drive for 24 hours if you were given a sedative.

Summary

  • Thoracoscopy is a procedure to examine your lungs and other structures in your chest.
  • The procedure uses a thin, lighted telescope with a camera (thoracoscope). Your health care provider inserts this instrument through a small surgical cut (incision) in your chest wall and uses it to look inside your chest.
  • Thoracoscopy may be done for various reasons. These include diagnosing a disease, removing a tissue (biopsy) or other sample, putting medicines into your lungs, or doing a minor surgical repair.

Thoracoscopy, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have pain and soreness in the surgical area.

Follow these instructions at home:

Incision care

  • Follow instructions from your health care provider about how to take care of your incision. Make sure you:
    • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
    • Change your dressing as told by your health care provider.
    • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
  • Check your incision areas every day for signs of infection. Check for:
    • Redness, swelling, or pain.
    • Fluid or blood.
    • Warmth.
    • Pus or a bad smell.
  • Do not take baths, swim, or use a hot tub until your health care provider approves. You may take showers.

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
  • Do not drive or use heavy machinery while taking prescription pain medicine.
  • If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
    • Drink enough fluid to keep your urine pale yellow.
    • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
    • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.
    • Take an over-the-counter or prescription medicine for constipation.

Managing pain, stiffness, and swelling

  • If directed, put ice on the affected area:
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag.
    • Leave the ice on for 20 minutes, 2–3 times a day.

Preventing lung infection

  • To prevent pneumonia and to keep your lungs healthy:
    • Try to cough often. If it hurts to cough, hold a pillow against your chest as you cough.
    • Take deep breaths or do breathing exercises as instructed by your health care provider.
    • If you were given an incentive spirometer, use it as directed by your health care provider.

General instructions

  • Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.
  • Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay healing after surgery. If you need help quitting, ask your health care provider.
  • Avoid driving until your health care provider approves.
  • If you have a chest drainage tube, care for it as instructed by your health care provider. Do not travel by airplane after the chest drainage tube is removed until your health care provider approves.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have a fever.
  • Pain medicines do not ease your pain.
  • You have redness, swelling, or increasing pain in your incision area.
  • You develop a cough that does not go away, or you are coughing up mucus that is yellow or green.

Get help right away if:

  • You have fluid, blood, or pus coming from your incision.
  • There is a bad smell coming from your incision or dressing.
  • You develop a rash.
  • You cough up blood.
  • You develop light-headedness, or you feel faint.
  • You have difficulty breathing.
  • You develop chest pain.
  • Your heartbeat feels irregular or very fast.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

  • Follow instructions from your health care provider about how to take care of your incision.
  • Do not drive or use heavy machinery while taking prescription pain medicine.
  • Leave stitches (sutures), skin glue, or adhesive strips in place.
  • Check your incision areas every day for signs of infection.
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