Pleuroscopy
Pleuroscopy is a procedure in which a physician can view the chest cavity and the lungs by inserting a thin tube through the chest wall. This tube is called pleuroscope and is a specialized instrument that contains a light and a camera that is attached to a video monitor. With this instrument, the physician can examine and diagnose problems in the chest, obtain tissue samples, drain any abnormal accumulation of fluid, and administer treatments to prevent fluid from building up (pleurodesis).
Risks
The complications of a pleuroscopy are uncommon. They include bleeding, infection of the pleural space, and injury to intrathoracic organs, atelectasis (decrease or loss of air in part or all of the lung), and respiratory failure.
Preparation
The patient may be asked to discontinue blood thinning medications (Clopidogrel and warfarin several days prior to the procedure. Blood tests may be needed before the procedure to ensure that the patient has no problems related to blood clotting.
Sedation and Analgesia
Pleuroscopy can be done in a special procedure suite. In most cases, intravenous (IV) sedative medications are given before and during the procedure to induce analgesia and relaxation. These medications often cause the person to forget what happened during the procedure. In the procedure area, the patient will given supplemental oxygen and will be connected to a pulse oximeter to monitor the blood oxygen level. Blood pressure and heart activity are also monitored throughout the procedure.
Procedure
The procedure will be done while the patient is lying on their side. The physician may use an ultrasound to locate the port of entry. Once this is marked an antiseptic solution is used to clean the surgical area, before administering local anesthetic. During the exam, the pleuroscope will be inserted through one or several small incisions in the chest.
Any abnormal fluid will be drained and any necessary tissue samples will be taken and sent to the laboratory for analysis
After the procedure, the lung will be reinflated and the incisions will be closed
A drainage tube may be left to allow any fluid or air to drain from the chest. The tube may be removed within hours, or may stay for one to two days after the procedure.
In some cases, to eliminate the abnormal re-accumulation of fluid, a special tube may need to remain in the chest cavity for several weeks or months
