Merck Manual

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Rebecca Dezube

, MD, MHS, Johns Hopkins University

Last full review/revision May 2021| Content last modified May 2021
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Thoracoscopy is the visual examination of the lung surfaces and pleural space through a viewing tube (a thoracoscope).

Thoracoscopy is used to view the lung and the space surrounding the lungs (pleural space). Doctors may use it to view the lungs and pleura when less invasive tests do not give conclusive results.

Thoracoscopy can also be used for certain surgical procedures. When it is used for surgery, the procedure is often referred to as video-assisted thoracoscopic surgery (VATS).

The most common means for obtaining a sample of lung tissue for a biopsy is with a thoracoscope. Besides being able to view the lung surface and pleura, a doctor may take samples of tissue for microscopic examination and culture. A thoracoscope also may be used to drain accumulations of fluid in the pleural space (pleural effusions). In certain cases, the doctor gives drugs through the thoracoscope to prevent a reaccumulation of fluid in the pleural space.

The person usually is given general anesthesia for VATS, but thoracoscopy can sometimes be done with the person awake but sedated. Then a surgeon makes up to three small incisions in the chest wall and passes a thoracoscope into the pleural space; this allows air to enter, collapsing the lung. After the surgical procedure, the thoracoscope is removed and a chest tube is inserted to remove air that entered the pleural space during the procedure, enabling the collapsed lung to reinflate.

Complications are similar to those for thoracentesis and include fever, bleeding, infection, and leakage of air into the pleural space (causing pneumothorax) or tissues under the skin around the incision if the lung is torn. However, this procedure is more invasive, leaves a small wound, and requires hospitalization.

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