A thoracoscopy is a medical procedure where a surgeon inserts a very long, thin tube called an endoscope into the body between the ribs. The tube has mirrors or a very small camera attached to it which allows the surgeon to see the internal organs and easily collect cells for the evaluation and diagnosis of mesothelioma, a type of cancer often caused by exposure to asbestos which is a substance once used in the manufacture of structural building materials.
Thoracoscopy is usually performed under general anesthesia although some hospitals have started using local anesthesia. Surgical Thoracoscopy is called Video-Assisted Thoracoscopy Surgery (VATS) and is done under general anesthesia in the operating room. VATS is performed by a thoracic surgeon. Since such a tiny incision is made, the need for more invasive surgery is alleviated. The diagnostic accuracy of thoracoscopy is 95%.
In cases of mesothelioma, the endoscope examines the lungs. This type of thorascopy is called pleuroscopy and is performed by a pulmonologist. It is named for the pleura which is the lining of the lungs.
During thoracoscopy surgery the patient is hooked up to a respirator to ensure easier breathing. The lung is partially or fully deflated in order to create enough space for the tiny camera to move around and see all areas of the lung in question. The surgeon then makes an incision in the chest between the ribs. The tube is inserted and begins exploring the area. Samples of suspicious cells can then be removed and sent to a lab where a pathologist will evaluate them for diagnosis.
After surgery, stitches or staples are used to close the incision. A drainage tube is placed in the chest in order to drain fluid buildup and release excess air in the chest cavity. The lungs are slowly brought back to full function and the patient is removed from the respirator. The chest tube usually stays in place for one to two days.
There are some risks involved in thoracoscopy because it requires the lung to be slightly or fully deflated for the endoscope to move throughout the area. This type of surgery can also be dangerous for patients with poor lung function, blood clots or heart disease.