Pleuroscopy or medical Thorascopy is the endoscopic procedure to peep into the pleural space. This is the space surrounding the lungs from outside. In normal scenario this is a small space containing little amount of lubricating fluid to avoid any friction between two layers covering the lungs during lungs movement of respiratory phases. In a large number of diseases there may be collection of huge amounts of abnormal fluid in this space. At times even lungs may rupture leading to collection of air around lungs. In both the cases a patient would need insertion of a tube to drain out abnormal collection of fluid/air outside lungs.
If the cause of fluid collection is not ascertained by initial investigations, in those scenarios’ biopsy of pleura the covering of lungs would be required. This biopsy, visualization and drainage of fluid is possible by procedure of Pleuroscopy/Medical thoracoscopy.
This is a minimally invasive procedure. After localizing fluid in the chest cavity using ultrasound study, site is marked and surrounding skin is anaesthetized with local anesthetic agent. Intravenous pain killers are given as per the need. Chest trocar is inserted pleural endoscope is advanced through chest cannula . PLaural surfaces can be visualized after draining the fluid, Pleural biopsy is obtained from outer covering (Parietal Pleura). This sample is sufficient for microbiological study, Cytology, histopathology, Immuno- Histo-chemistry (IHC) and genetic mutations.
Post-procedure a draining tube is usually left in the place to drain remaining collection until the lung inflates fully .