Medical thoracoscopy is usually performed by Pulmonologists in the endoscopy suite under local anesthesia and with intravenous conscious sedation/analgesia.
Medical Thoracoscopy
Medical Thoracoscopy
Indications
- Any undiagnosed pleural effusions
- Pleurodesis with talc insufflation through thoracoscope.
- Parapneumonic effusions and acute empyema with risk – benefit stratification over vats ( video assisted thoracoscopic surgery) with help of ultrasonography and CT thorax.
Before The Test
- Routine hematological and biochemical blood analysis
- Coagulation parametres
- Medications reviewed including blood thinners
- Imaging( x-ray chest, usg , ct scan of lung)
- Evaluation of comorbities
- Previous pleural fluid / pus analysis
- Talc powder for pleurodesis
During The Test
- Thoracoscopy usually done in operation theatre under local or general anesthesia by anesthetist depending upon the indication.
- Usally patient has to lying down in left or right lateral position on o.t. Table.
- Pleural biopsies, adhesiolysis and drainage of pleural collections are to be done through trocar inserted into intercostal space with usg guidance.
- Simultaneous talc powder insufflation done if indicated
After The Test
- Intercostal chest drainage tube is inserted into pleural cavity and attached with underwater seal.
- X-ray chest is reviewed for lung expansion.
- You are advised to stay nil by mouth for some hours after procedure due to effect of anesthesia.
- You are advised to stay in hospital for 24 hours or 3 to 5 days depending upon clinical indication.
- Sometimes you are discharged with ICD tube in situ.
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