Indications

• Any undiagnosed pleural effusions
• Pleurodesis with talc insufflation through thoracoscope.
• Parapneumonic effusions and acute empyema with risk – benefit stratification over vats ( video assisted thoracoscopic surgery) with help of ultrasonography and CT thorax.

Before The Test

• Routine hematological and biochemical blood analysis
• Coagulation parametres
• Medications reviewed including blood thinners
• Imaging( x-ray chest, usg , ct scan of lung)
• Evaluation of comorbities
• Previous pleural fluid / pus analysis
• Talc powder for pleurodesis

During The Test

• Thoracoscopy usually done in operation theatre under local or general anesthesia by anesthetist depending upon the indication.
• Usally patient has to lying down in left or right lateral position on o.t. Table.
• Pleural biopsies, adhesiolysis and drainage of pleural collections are to be done through trocar inserted into intercostal space with usg guidance.
• Simultaneous talc powder insufflation done if indicated

After The Test

• Intercostal chest drainage tube is inserted into pleural cavity and attached with underwater seal.
• X-ray chest is reviewed for lung expansion.
• You are advised to stay nil by mouth for some hours after procedure due to effect of anesthesia.
• You are advised to stay in hospital for 24 hours or 3 to 5 days depending upon clinical indication.
• Sometimes you are discharged with ICD tube in situ.