Name of the Procedure:

Thoracoscopy; with diagnostic biopsy(ies) of lung infiltrate(s) (e.g., wedge, incisional), unilateral. Commonly referred to as Video-Assisted Thoracoscopic Surgery (VATS) biopsy.

Summary

A thoracoscopy with biopsy is a minimally invasive procedure used to examine the lungs and take tissue samples. It involves inserting a small camera (thoracoscope) and instruments through tiny incisions in the chest to visually inspect lung infiltrates and obtain a biopsy.

Purpose

This procedure is performed to diagnose lung conditions such as infections, inflammation, or cancer by obtaining tissue samples that are examined under a microscope. The goal is to identify the underlying cause of lung abnormalities and plan appropriate treatment.

Indications

• Persistent cough
• Unexplained chest pain
• Abnormal lung imaging results (e.g., X-rays, CT scans)
• Suspected lung infections or tumors
• Unexplained pleural effusion (fluid around the lungs)

Preparation

• Patients may be instructed to fast for a specific period before the procedure.
• Certain medications may need to be adjusted or stopped.
• Pre-procedure tests such as blood work and imaging studies are often required.

Procedure Description

1. The patient is given general anesthesia to ensure they are asleep and pain-free.
2. Small incisions are made in the chest.
3. A thoracoscope is inserted through one of the incisions to view the lung infiltrates.
4. Surgical instruments are inserted through other incisions to take tissue samples via wedge or incisional biopsy.
5. The tissue samples are sent to a lab for analysis.
6. The incisions are closed with sutures or staples, and a chest tube may be placed to drain any fluid or air.

Duration

The procedure typically takes 1-2 hours.

Setting

Thoracoscopy with biopsy is usually performed in a hospital operating room or a specialized surgical center.

Personnel

• Thoracic Surgeon
• Anesthesiologist
• Surgical Nurses
• Operating Room Technicians

Risks and Complications

• Bleeding
• Infection
• Pneumothorax (collapsed lung)
• Pain or discomfort at the incision sites
• Adverse reactions to anesthesia

Benefits

• Accurate diagnosis of lung conditions
• Minimally invasive with smaller incisions and quicker recovery compared to open surgery
• Allows for direct visualization of lung tissues

Recovery

• Patients may stay in the hospital for 1-2 days post-procedure.
• Instructions for wound care, activity limitations, and medications will be provided.
• Most patients can return to normal activities within 1-2 weeks.
• Follow-up appointments are necessary to monitor recovery and discuss biopsy results.

Alternatives

• Bronchoscopy with biopsy
• Needle biopsy (Transthoracic needle aspiration)
• Open lung biopsy (more invasive) Each alternative has its own pros and cons concerning invasiveness, accuracy, and recovery time.

Patient Experience

Patients will not feel anything during the procedure due to general anesthesia. Post-procedure, they may experience chest pain, discomfort, or swelling at the incision sites, which can be managed with prescribed pain medications. Most patients recover quickly and can resume normal activities relatively soon.