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Cost of Thoracoscopy & Lung Biopsy in Delhi

  • Posted on- Apr 18, 2018
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THORACOSCOPY

Thoracoscopy is a process in which a thin flexible viewing tube (called a thoracoscope) is inserted through a small incision made in the chest. Fiberoptic cables enable the surgeon to visually check the lungs, mediastinum (the area between the lungs), and pleura (the membrane covering the lungs and lining the chest cavity). In addition, surgical instruments may be put through other small incisions which have been made in the chest to perform both diagnostic and therapeutic procedures.

Purpose of the Thoracoscopy

  • To visually inspect the lungs, pleura, or mediastinum for evidence of abnormalities
  • To get tissue biopsies or fluid samples from the lungs, pleura, or mediastinum in order to treat infections, cancer, and other diseases
  • Used therapeutically to remove excess fluid in the pleural cavity or pleural cysts, or to remove a portion of diseased lung tissue (wedge resection).
  • To check patients with pulmonary disease or abnormalities of the sac that surround the heart (pericardium) or the lining of the chest (pleura)
  • To obtain a tissue sample (biopsy) for further evaluation and to diagnose inflammation, infection, fibrosis and cancer
  • As a minimally-invasive method to perform certain types of surgery, such as pericardiectomy

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Who Performs Thoracoscopy

A chest surgeon or pulmonary specialist with a surgical team

Before the Thoracoscopy

  • The doctor has to know if the patient regularly takes anticoagulants, nonsteroidal anti-inflammatory drugs (such as aspirin, ibuprofen, or naproxen), or any other medications. He may be instructed to discontinue certain drugs before the test.
  • Do not eat or drink anything for 12 hours before the test.
  • Immediately before the test, an intravenous (IV) needle or catheter is inserted into a vein in the arm, and the patient will be placed under general anesthesia.

What the patient will Experience during Thoracoscopy

  • A thin tube is inserted through the mouth and into the lungs. The lung on the operative side is partially or completely deflated to create space between the lung and chest wall and provide the surgeon with a clear view of the area.
  • The surgeon makes several small incisions in the chest and inserts drainage tubes to remove blood during the procedure. The scope is passed into the space between the lung and chest wall fiberoptic cables transmit images of the area onto a TV screen in the operating room. The scope may be moved to different locations as needed.
  • Following the inspection of the lung and pleura, the doctor may insert surgical instruments through small incisions to remove tissue or fluid for diagnostic examination or as a therapeutic measure.
  • The scope and all the other instruments are removed the collapsed lung is re-expanded and all the incisions too but one is closed with stitches or adhesive tape. A thin tube is placed in the remaining incision and left there for 1 to 2 days, in order to drain air and fluid from the chest.
  • The procedure will take around 45 to 90 minutes.

Risks and Complications of Thoracoscopy

  • General Anesthesia will be required in Thoracoscopy, and thus carries the associated risks.
  • Rare complications include excessive bleeding, infection, perforation of the diaphragm, and pneumothorax (leakage of air outside the lungs and into the pleural cavity, resulting in a collapsed lung).

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After the Thoracoscopy

  • The will remain in the hospital up to several days until he recovers from the effects of surgery and anesthesia. During this time, the vital signs will be monitored, and the patient will be observed for any signs of complications.
  • The patient may be given pain-relieving medication to allay the discomfort associated with surgery.
  • A chest x-ray will be performed to ensure complete re-inflation of the lung.

What are the different tests which have to be performed before Thoracoscopy?

Some of the different tests which have to be performed before Thoracoscopy are:

LUNG BIOPSY

A tissue sample is taken from the lung for laboratory analysis the specimen is taken from an area that appears altered due to disease. Several techniques may be used, including needle biopsy, in which a long needle is passed through the chest wall and into the lung, and open biopsy, which accesses the lung surgically through a small incision.

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Tissue specimens may also be taken by passing a tube-like viewing instrument (endoscope) through the airways (bronchoscopy) or chest wall (thoracoscopy).

Purpose of the Lung Biopsy

To confirm a diagnosis of lung disease, such as inflammatory conditions, infection, or cancer— especially after a chest x-ray, CT scan, and bronchoscopy have failed to provide a conclusive diagnosis

Who Performs It

  • Needle biopsy is conducted by a physician, assisted by a radiology technician.
  • An open biopsy is performed by a chest surgeon and surgical team.

Before the Lung Biopsy

  • The doctor should be informed if the patient regularly takes anticoagulants or non-steroidal anti-inflammatory drugs (such as aspirin, ibuprofen, or naproxen). He will be instructed to discontinue them for some time before the test. Also, mention any herbs or supplements that the patient takes.
  • The doctor should know if the patient is diabetic and taking insulin.
  • Notify the doctor of any allergies, about the patient’s recent illnesses and other medical conditions.
  • Women should inform the doctor if she is pregnant.
  • The patient should not eat or drink anything for 8 to 12 hours before the procedure. (Sometimes clear fluids are allowed the morning of the test).
  • At the testing facility, the patient will be asked to disrobe and put on a hospital gown.
  • Before undergoing a needle biopsy, the doctor may give the patient a sedative, if necessary.
  • Immediately before the open biopsy, an intravenous (IV) needle or catheter is inserted into a vein in patient’s arm, and he will be placed under general anesthesia. A thin tube attached to a breathing machine is inserted through the windpipe to ensure patient breathe properly during the procedure.

What the Patient experience during Surgery

Needle biopsy:

  • The patient is asked to either sit with the arms supported on a table or lie down on stomach or back. The doctor will advise him to remain still and avoid coughing during the procedure to reduce the risk of needle damage to the lung.
  • The skin is made clean and a local anesthetic is injected to numb the area where the biopsy needle will be inserted.
  • The doctor inserts a thin biopsy needle through the chest wall into the lung (sometimes through a small incision made with a scalpel). Fluoroscopic imaging or CT scanning is used to guide the placement of the needle.
  • The patient will be asked to hold his breath during needle insertion. A tissue specimen is obtained and the needle is withdrawn.
  • Pressure is placed on the incision site until bleeding has stopped, and a small bandage is applied.
  • The procedure takes 30 to 60 minutes.

Open biopsy:

  • The patient is positioned on his back or side, and an incision is made in the chest.
  • A portion of lung tissue is removed with surgical instruments, and the lung is sutured closed.
  • A chest tube is left in place for about 24 hours, in order to drain fluid and air from the chest.
  • An open lung biopsy can take 2 to 4 hours.

Risks and Complications

  • Possible serious complications include bleeding in the lungs, infection, inadvertent needle-induced damage to the lung, or pneumothorax.
  • An open biopsy may have risks associated with general anesthesia.

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After the Lung Biopsy

  • The patient will remain in a recovery room for up to 3 hours after a needle biopsy he may be hospitalized for 3 to 7 days after an open biopsy. During this time, vital signs will be monitored and the patient will be observed for any signs of complications.
  • The patient may be given pain-relieving medication to allay any discomfort around the biopsy site.
  • The patient may cough up small amounts of blood temporarily. If it persists for more than 72 hours, notify the doctor.
  • A chest x-ray is done after a needle biopsy to ensure that a pneumothorax has not developed.
  • Upon returning home after a needle biopsy, avoid strenuous activity for at least 24 hours.
  • Go to the nearest emergency room if the patient experience chest pain or difficulty breathing.

What are the different tests which have to be performed before Lung Biopsy?

Some of the different tests which have to be performed before Lung Biopsy are:

  1. Chest X-rays
  2. CT Scan
  3. Blood Test
  4. Bronchoscopy


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