Thoracoscopy Lung Investigation Service

Thoracoscopy
Lung Investigation Service
Patient Information Leaflet
Originator: Dr M Chaudir/ Dr P Brammer
Date: October 2011
Version: 1
Date for Review: October 2014
DGOH Ref No: DGOH/PIL/00280
Thorascoscopy
Useful Telephone Numbers:
The Purpose of this leaflet is to answer any questions you may
have about having a Thoracoscopy. If you are unsure of anything,
please do not hesitate to ask the Doctors and Nurses caring for
you.
Russells Hall Hospital
GI Unit
01384 456111 ext 2113 or 2390
Why do I need a Thoracoscopy?
There are several reasons why a Thoracoscopy may be required.
In most cases it is to make a diagnosis - to find out what is causing
your chest symptoms. It is to allow us to drain fluid from around the
lungs.
Dr Chaudri's Secretary
01384 456111 ext 2568
Lung Nurse Specialists
Lucia Sabel and Kim Homer
01384 456111 ext: 2752
What is Thoracoscopy?
A Thoracoscopy involves putting a small telescope into the chest
through a little hole (about 1-2cm). This allows us to see inside
your chest. We can then drain away any fluid and may also take
samples from the lining of the ribcage.
Do I take my usual tablets?
Yes, you should continue to take all your usual medication unless
advised not to do so by your Doctor.
If you take Warfarin or Clopridogel tablets these will need to be
stopped before your Thoracoscopy.
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Are there any alternatives to a
Thoracoscopy?
What happens on the day of my
Thoracoscopy?
We can sometimes get a sample of the lining of the chest wall but
doing a test called a 'CT guided pleural biopsy'. This is also done
under local anaesthetic, but unlike a Thoracoscopy we cannot look
inside the chest and we cannot drain away any fluid.
Before the Thoracoscopy you must not have anything to eat or
drink for 6 hours. Bring an overnight bag with you as most people
stay in hospital afterwards.
As with all tests, if you are not happy to have the Thoracoscopy
you can always say no. Your Doctor should have discussed the
options with you. If you have any questions please ask the Doctors
and Nurses looking after you.
Will I be put to sleep for the test?
No, you will not need a general anaesthetic. You will be given
some medicine to make you feel relaxed or even sleepy before the
test - this is called premedication.
Aftercare advice
How is the Thoracoscopy performed?
Following the procedure you will have a small incision wound. This
will need to be kept dry until healed. If you have a suture remaining
following discharge from hospital you will be advised when this
should be removed at your GP surgery.
The Thoracoscopy is performed in the operating theatre. You will
be asked to lie on your side and will be given oxygen.
You will be given an injection to help you relax. Once you are as
comfortable as possible, some local anaesthetic will be injected
into your side to numb the skin. Once your skin is numb, a small
hole is made to allow the telescope to pass into your chest. You
may feel some pushing at this stage.
Any fluid around your lung will be drained away and samples of the
lining of the ribcage will be taken.
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Sometimes we try to stop the fluid coming back. This is called
Pleurodesis. A powder (purified talc) is put into the space between
the lung and the ribcage to try and stick the lung to the ribcage.
This is done through the telescope. Not everyone needs this
treatment. We will let you know if you need a Pleurodesis.
At the end of the Thoracoscopy a tube will be passed into your
chest and connected to a bottle on the floor. This is called a chest
drain.
The chest drain will usually stay in for a few hours or a few days
depending on the amount of fluid drained after the procedure.
The whole test takes about 40 to 60 minutes.
Pain - Although painkillers and local anaesthetic are given,
some people do experience pain during or after the
procedure. You can have more painkillers if you need them.
Bleeding - a small amount of bleeding around the site is
expected and usually resolves quickly without treatment. More
serious bleeding or damage to other organs in the chest is
extremely rare (less than 1 in a 1000 people), but if this were
to happen, surgery may be required.
Infection - there is a slight risk of introducing infection into the
chest. If this were to happen we might need to leave the chest
drain in for a few more days.
The talc that is used for Pleurodesis can sometimes cause
inflammation of the lungs. This may cause breathlessness but
usually settles quickly.
What happens after the Thoracoscopy?
When can I go home?
Afterwards the nursing staff will observe you closely by recording
your blood pressure and pulse at regular intervals. You will need a
chest x-ray and be transferred to a ward.
Most people can go home within 1-3 days.
Are there any risks of having a
Thoracoscopy?
When will I get the results?
It normally takes up to a week for your specimen to be examined
under the microscope. We will make an appointment to discuss the
results with you in the clinic.
A Thoracoscopy is generally a very safe procedure but there are
some risks:
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