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The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on April 2, 2021.

Thoracoscopy

Thoracoscopy is a procedure use
d to look inside your chest, right outside of your lungs. It’s performed with a thoracoscope, a thin, tubular instrument with a light and camera attached to it. It’s considered a minimally invasive procedure, because only small incisions are needed. Typically, it’s used to detect or treat disease forming in the chest cavity or deliver medicine directly to an area in your chest. 

Often, a video is used to help guide the procedure.

Why it's performed

Your doctor may feel thoracoscopy is needed to:

This procedure may be recommended if you have difficulty breathing or are coughing up blood.

Thoracoscopy is often used to examine tissue that looks abnormal on an imaging test such as a chest X-ray or CT scan. The procedure can also be used to take biopsies of suspicious-looking:

  • Lung tissue
  • Lymph nodes
  • Tissue of the chest wall
  • Pleura (tissue that lines the lungs)

This might occur with lung cancer or mesothelioma.

Treat small lung tumors

Thoracoscopy is sometimes used to remove the portion of a lung that contains a tumor (a procedure called wedge resection) or, if the tumor is bigger, the lobe of the lung (lobectomy). In some cases, the scope may be used to treat cancer in the esophagus or thymus gland.

Remove fluid around the lungs

Thoracoscopy can remove excess fluid that may be causing breathing difficulties. Your doctor may send the fluid to a lab to check for signs of cancer or infection. If fluid is extracted but builds up again, a thoracoscope can be used to place medication in the chest cavity to stop another recurrence, a procedure called pleurodesis.

How to prepare

Make sure your care team is aware of any medications you take, including any supplements, vitamins and herbs. Also, be sure to mention any allergies to medications.

Your care team may instruct you to stop taking any medications that thin the blood, such as aspirin, for a number of days prior to the procedure and to stop eating or drinking anything in the hours beforehand.

What to expect

The thoracoscopy procedure may be done on an outpatient basis (no overnight stay in the hospital) or on an inpatient basis (with a stay in the hospital for one or more nights).

With an inpatient thoracoscopy, you’ll likely receive general anesthesia via an intravenous line (IV). You’ll breathe through a tube placed in your throat that’s attached to a special machine. If you’re an outpatient, you’ll receive local anesthesia and a sedation to make you groggy. 

For the thoracoscopy itself, a small incision is made near the lower section of the back shoulder blade and the thoracoscope is inserted. Other small incisions may be needed, depending on what your doctor wants to accomplish. For instance, one may be made beneath the underarm on the same side to insert the instrument that takes a tissue sample for lab testing. If it’s necessary to remove fluid, an incision will be made in the lower chest wall and another tube inserted. The procedure takes about 30 to 90 minutes, depending on your circumstances.

After the procedure, all incisions will be closed and you’ll go back to breathing on your own. You’ll be monitored closely to make sure there are no issues. As the anesthesia wears off, you’re likely to feel woozy and experience some confusion for a period of hours and your mouth and throat will be numb. You won’t be able to eat or drink until the numbness subsides. At that point, you may experience hoarseness, coughing and/or a sore throat for about a day. You also may experience numbness or pain at the incision sites. 

If you undergo outpatient thoracoscopy, you’ll likely be able to go home a few hours afterward but will need a ride home due to the lingering effects of anesthesia. Your care team will provide you with postoperative instructions that need to be followed closely. It should include a list of signs of symptoms that require a call to your care team, such as:

  • Fever
  • Difficulty breathing
  • Chest pain
  • Coughing up blood

Risks

Potential risks of thoracoscopy include:

  • Bleeding
  • Pneumonia (lung infection)
  • Infection at an incision site 
  • Pneumothorax (partial lung collapse)
  • The need for thoracotomy, a procedure in which the chest cavity is opened via a larger incision because the surgeon was unable to perform the procedure with the smaller cut 

If you’re having any symptoms following the procedure, your care team may take a chest X-ray to look for pneumothorax and other issues.

Your results

Why the test was done will determine how soon you get results. For example, you may find out if any abnormal areas were detected right away. If a biopsy was taken, it may take a few days or longer to receive the report.