Thoracoscopy (pleural biopsy, pleural effusion, pneumothorax)

The pleura is the thin membrane that surrounds the lungs. Fluid can build up within it (pleural effusion), air can leak into it and cause the lung to collapse (pneumothorax), or it can develop lesions whose nature needs to be determined. Thoracoscopy makes it possible to see inside the chest and treat the problem without opening the chest widely. The procedure is usually performed under general anaesthesia. The surgeon makes one to three small incisions between the ribs and introduces a camera connected to a screen, along with fine instruments. Depending on the situation, the surgeon takes samples of the pleura for analysis (biopsy), drains an effusion and breaks down the partitions that divide it, removes the small air blisters responsible for a pneumothorax, and makes the layers of the pleura stick together (pleurodesis) to prevent recurrence. A chest drain is left in place at the end. It is offered for a pleural effusion of unknown cause, an infected or recurrent pleural effusion, or a pneumothorax that recurs or does not resolve with simple drainage. At Clinique Pasteur Tunis, thoracoscopy is performed in the operating theatre with a video-surgery system, by thoracic surgeons, with suitable post-operative monitoring and, if needed, a stay in intensive care.