Name of the Procedure:

Thoracoscopy with Diagnostic Biopsy(ies) of Lung Nodule(s) or Mass(es) (e.g., Wedge, Incisional), Unilateral

• Common names: Thoracoscopic Lung Biopsy, VATS (Video-Assisted Thoracic Surgery) Biopsy

Summary

Thoracoscopy is a minimally invasive surgical procedure that allows doctors to examine the thoracic (chest) cavity and take biopsies of lung nodules or masses. This procedure is done using a thoracoscope, a type of endoscope inserted through small incisions in the chest.

Purpose

The procedure is performed to diagnose abnormalities in the lung, such as nodules or masses. The goal is to obtain tissue samples for pathological examination to identify any infection, inflammation, or cancer.

Indications

• Unexplained lung nodules or masses detected on imaging studies (e.g., CT scan, X-ray)
• Persistent cough, chest pain, or shortness of breath
• Unexplained fluid accumulation in the chest
• Suspected lung cancer or metastases

Preparation

• Patients may need to fast for several hours before the procedure.
• Certain medications, especially blood thinners, may need to be adjusted or stopped.
• Pre-procedure tests may include blood work, imaging studies, and a pulmonary function test.

Procedure Description

1. The patient is administered general anesthesia to ensure they are unconscious and pain-free.
2. Small incisions (ports) are made in the chest wall.
3. A thoracoscope (a thin, flexible tube with a camera and light) is inserted through one of the incisions.
4. Additional instruments are introduced through other incisions to take biopsy samples from the lung nodules or masses.
5. The tissue samples are collected and sent to a laboratory for analysis.
6. The thoracoscope and instruments are removed, and the incisions are closed with sutures or staples.

Duration

The procedure usually takes about 1 to 2 hours.

Setting

This procedure is typically performed in a hospital operating room or a specialized surgical center.

Personnel

• Thoracic Surgeon
• Anesthesiologist
• Surgical Nurses
• Scrub Technicians

Risks and Complications

• Common risks: Pain, infection, bleeding
• Rare risks: Pneumothorax (collapsed lung), anesthesia complications, damage to nearby organs
• Management of complications may involve additional medical or surgical interventions.

Benefits

• Minimally invasive with smaller incisions and quicker recovery compared to open surgery.
• Provides an accurate diagnosis to guide further treatment.
• Reduced post-operative pain and shorter hospital stay.

Recovery

• Patients are usually monitored in the recovery room before being transferred to a hospital room.
• Pain management includes prescribed medications and may involve a chest tube to drain fluid or air.
• Most patients can return to normal activities within 1 to 2 weeks, but full recovery may take several weeks.
• Follow-up appointments are essential to monitor healing and review biopsy results.

Alternatives

• Needle biopsy: Less invasive but may not obtain sufficient tissue.
• Bronchoscopy: Less invasive but limited by the location of the nodule or mass.
• Open lung biopsy: More invasive with larger incisions but allows for a more extensive examination.

Patient Experience

During the procedure, patients are under general anesthesia and feel no pain. After the procedure, some discomfort or pain at the incision sites is expected, which is managed with pain relief medications. Patients may experience some fatigue during recovery but can usually gradually return to their regular activities.