Your lung specialist or primary care physician may be referring you to our practice for:
- Evaluation of a lung mass: a nodule or growth in one of your lungs
- Evaluation of a mediastinal mass: a growth or enlarged lymph nodes in the central compartment of the chest
- Lung biopsy to help guide management of your lung disease
- Management of a recurrent collapsed lung, or pneumothorax
- Management of a recurrent fluid collection around one of your lungs (pleural effusion)
One of the following procedures may be required:
BRONCHOSCOPY
This is a procedure in which, under sedation, a small flexible scope is passed into the airways supplying your lungs. This provides direct vision of the trachea (windpipe) and bronchi (airways of the lungs) and allows verification of infections, biopsy of tumors, localization of bleeding, and removal of secretions.
Mediastinoscopy
This is a procedure in which a scope is passed through a small incision at the base of your neck in order to evaluate the mediastinum (the central compartment of the chest between the lungs). This is an outpatient procedure but requires general anesthesia. Mediastinoscopy is often used for biopsy of enlarged lymph nodes that may be involved with infection or cancer.
Pleural or Chest Tube Placement
Using local anesthetic, a tube is inserted into the pleural space (the space around the lungs) and may be required to drain fluid, blood or pus, or to evacuate air that has leaked out of the lungs (pneumothorax). Drainage or the leakage of air is monitored daily and when it has subsided and the lung function is stable, the chest tube can be removed.
Thoracotomy
Thoracotomy is an incision used to enter the chest. It is commonly placed towards the back, under the shoulder blade. The muscles of the chest wall are moved and the ribs are spread allowing entry to the chest cavity. This incision is commonly used to perform various procedures such as:
- Lobectomy- removal of a lobe or portion of the lung, usually for cancer
- Pneumonectomy- removal of an entire lung, usually for cancer
- Decortication- removal of a restrictive fibrous “peel” that has formed over the lung as a result of a chronic infection
- Wedge biopsy- removal of a piece of lung tissue or a discrete lung mass or nodule for pathologic evaluation.
Video Assisted Thoracoscopy (VATS)
Several of the above procedures can now be accomplished by a less invasive technique. The thoracoscope is an illuminated scope attached to a camera allowing video inspection of the intrathoracic anatomy. Instead of a thoracotomy, the thoracoscope is introduced through a small incision in the lower portion of the chest. Through other small incisions, special instruments are introduced to accomplish the intended surgical procedure.
