32653 Thoracoscopy, surgical; with removal of intrapleural foreign body or fibrin deposit

Name of the Procedure:

Thoracoscopy, surgical; with removal of intrapleural foreign body or fibrin deposit

Summary

Thoracoscopy is a minimally invasive surgical procedure that allows doctors to view the chest cavity and perform interventions such as removing foreign bodies or fibrin deposits within the pleura (the lung's outer lining).

Purpose

This procedure addresses issues such as the presence of foreign objects or fibrin deposits within the pleural space, which can cause pain, infection, or impaired lung function. The aim is to improve lung function, reduce symptoms, and prevent complications.

Indications

• Persistent chest pain
• Difficulty breathing
• Recurrent pleural effusions
• Suspicion of foreign objects or fibrin deposits in the pleural space
• Persistent pleuritis or empyema not responsive to non-surgical treatment

Preparation

• Fasting for at least 6-8 hours before the procedure
• Adjustments to current medications, particularly blood thinners
• Pre-procedure imaging tests such as a chest X-ray or CT scan
• Pulmonary function tests or blood tests as deemed necessary

Procedure Description

1. The patient is placed under general anesthesia.
2. Small incisions are made in the chest wall.
3. A thoracoscope (a thin, flexible tube with a camera) is inserted to visualize the pleural cavity.
4. Specialized surgical instruments are introduced through additional small incisions.
5. The surgeon identifies and removes the foreign body or fibrin deposits.
6. The pleural space is inspected for bleeding or other abnormalities.
7. The instruments are removed, and the incisions are closed with sutures or surgical staples.

Duration

The procedure typically takes between 1 to 2 hours, depending on the complexity.

Setting

Thoracoscopy is generally performed in a hospital operating room.

Personnel

• A thoracic surgeon
• An anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection
• Bleeding
• Pneumothorax (collapsed lung)
• Reaction to anesthesia
• Rarely, injury to nearby organs such as the lungs or diaphragm
• Pain or discomfort at the incision sites

Benefits

• Relief from symptoms such as pain and difficulty breathing
• Improved lung function
• Prevention of further complications or infections
• Quick recovery time compared to open thoracic surgery

Recovery

• Monitoring in a recovery room for several hours post-procedure
• Pain management with prescribed medications
• Instructions on wound care and activity limitations
• Follow-up appointments to monitor recovery and remove any remaining stitches or staples
• Most patients can return to normal activities within 1-2 weeks

Alternatives

• Non-surgical management, such as medication or chest tube drainage
• Open thoracotomy, which is more invasive and requires a longer recovery period
• Observation and ongoing imaging studies in cases where intervention may not yet be required

Patient Experience

Patients will be under general anesthesia and will not feel or remember the procedure. Post-operatively, they may experience soreness and mild pain at the incision sites, which can be managed with pain medication. Full recovery typically takes 1-2 weeks, with a gradual return to normal activities.