Process of Pleuroscopy

Less invasive procedures are becoming more and more popular as the risks are lower and the recovery time is quicker. A pleuroscopy is one such procedure that can be used as an alternative for other more invasive procedures such as a video-assisted thoracic surgery.

What is a Pleuroscopy?

A pleuroscopy, also known as a medical thoracoscopy, is a minimally invasive procedure used to examine the inside of your pleural cavity. The pleural cavity is the fluid-filled space between your lungs and the pleural membranes.  It plays an important role in helping the lungs to expand and contract and the fluid within the pleural cavity also acts as a lubricant which aids in this movement.

A pleuroscopy involves a long and thin tube, called a pleuroscope, with a camera and light attached at one end. It is usually used as a second line of diagnosis after other less invasive procedures such as a computed tomography scan (CT-scan), ultrasound, and a thoracentesis (pleural fluid is extracted using a needle). A pleuroscopy has 4 general functions, these are:

  • Diagnosis: helps to check the pleural cavity for abnormalities associated with infections (e.g., tuberculosis) and malignancy (e.g., lung cancer and mesothelioma or cancer of the pleura).
  • Biopsy: samples are taken to check for signs of abnormalities such as cancer or infections.
  • Drainage: drains the excess fluid of a pleural effusion. This excess fluid can also be sent for a biopsy to check for any signs of cancer. 
  • Preparation for a pleurodesis: a procedure where the lungs are stuck to the chest wall, thus preventing, or reducing the chances of recurrent pneumothorax or pleural effusion.

How does a Pleuroscopy work?

A pleuroscopy may be performed as an in-patient or out-patient procedure, depending on the test required – diagnostic or drainage and pleurodesis. It may take anywhere from 30-90 minutes.

  • An anaesthesia is administered intravenously to help you relax and remove any discomfort you may feel. 
  • The optimal position for insertion will be determined via a CT- scan or ultrasound.
  • Small incision approximately 1-2cm is made and any fluid is drained first before the pleuroscope is inserted.
  • Once the pleuroscope is inserted, your respiratory specialist will be able to examine the insides of your pleural cavity via the small camera on the pleuroscope.
  • Samples may be taken and sent for a biopsy.
  • Once all the required procedures are done, the pleuroscope is slowly removed and a chest drain is inserted and stitched into the incision to drain any excess fluid.

What happens after a Pleuroscopy procedure in Singapore?

You may feel a bit groggy after the procedure, so you will be monitored for a few hours to ensure that you recover well. You may also experience some discomfort from the chest tube. A chest x-ray might be performed after the pleuroscopy to ensure that no damage was done to your lungs.

It may be possible to remove the chest drain after a few hours; however, it may be kept in for a few days in some individuals. If the chest drain is kept in for longer, it is attached to a drainage bottle which has a gentle suction. This may cause increased discomfort so painkillers will be administered. 

Once all the excess fluid has been drained, the chest tube is removed, and the incision is closed with stitches.

Who needs a Pleuroscopy?

A pleuroscopy is required for the following:

  • Diagnosis of tuberculosis and cancer
  • Drainage of a pleural effusion
  • Drainage in preparation for a pleurodesis
  • Biopsy, where samples are taken via a pleuroscopy

How do I prepare for a Pleuroscopy in Singapore?

Before the procedure, you must avoid eating and drinking for 6-12 hours and you may be required to stop certain medications such as blood thinners and aspirin. Either a sedative or general anaesthesia is used during the procedure, depending on your preference and advice of your respiratory specialist. 

What are the benefits of a Pleuroscopy?

  • Minimally, relatively short procedure
  • Accurate diagnosis of tuberculosis and cancer
  • Safe and well-tolerated procedure

What are the common possible complications or risks of a Pleuroscopy in Singapore?

There are minimal to no risks or complications involved in a pleuroscopy in Singapore, however, like all medical procedures, a small number of individuals might experience some complications or risks. These are:

  • Adverse reaction to anaesthesia
  • Pneumonia
  • Bleeding from site of incision or biopsy
  • Pneumothorax (collapsed lungs)
  • Infection
  • Pain at the site of incision or from chest tube during drainage

Frequently asked questions

How long does it take to recover from a pleuroscopy?

Full recovery takes about 4-6 weeks after the procedure. 

Will I be able to go home after the procedure?

This depends on the reason for the pleuroscopy and what was done during the procedure. If the pleuroscopy was used for drainage of a pleural effusion or in preparation for a pleurodesis, you will have to stay in the hospital for a few days. However, if the pleuroscopy was performed for diagnosis or biopsy purposes, you may be able to go home on the same day, subject to your doctor’s approval. 

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