What Is a Thoracoscopy?
Video-assisted thoracoscopy surgery is the gold standard in diagnosing many cases of mesothelioma.
This biopsy technique involves making small incisions in the chest to insert a thoracoscope — a thin tube equipped with a camera and light — into the pleura (lining of the lungs). Doctors can then remove a biopsy sample and study it under a microscope to determine if you have cancer.
“Even though it’s a surgical procedure, it requires only a one-centimeter incision, and it will provide adequate tissue to lead to that diagnosis more rapidly so patients can be treated adequately.”
Key Facts About Mesothelioma Thoracoscopy
- Also known as: Pleuroscopy or video-assisted thoracoscopic surgery (VATS)
- Benefits: Minimally invasive procedure; more than 9 in 10 patients get correctly diagnosed
- Possible side effects: Pain, infection, bleeding, and lung complications (collapsed lung or pneumothorax)
- When it’s used: To help diagnose pleural mesothelioma and, in some cases, relieve pain
- How it works: A camera is inserted into pleural space and chest wall to look for signs of cancer
Use our Free Doctor Match to connect with specialists who diagnose and treat mesothelioma. It only takes a few seconds to get started.
Who Is Eligible for a Mesothelioma Thoracoscopy?
Patients who may have malignant pleural mesothelioma may be eligible for thoracoscopy surgery.
Several factors can affect your eligibility for thoracoscopy surgery, including:
- Overall health: You should be in good health to get a thoracoscopy. A different type of biopsy could be safer if you have other medical conditions.
- Pleural thickening: This is a condition where the lung lining is inflamed, which could prevent doctors from accessing the pleural cavity using a thoracoscopy.
- Sensitivity to anesthesia: Patients will need to get anesthesia for thoracoscopy surgery. Be sure to discuss any sensitivities to anesthesia with your doctor beforehand.
Mesothelioma doctors can determine if a thoracoscopy will work best for you. If not, there are other ways to get a biopsy and confirm a mesothelioma diagnosis.
What to Expect During Thoracoscopy Surgery
Doctors administer a thoracoscopy using the steps below. View each step and find out what to expect.
1. Receive Local or General Anesthesia
You’ll receive anesthesia to ensure you are pain-free during a thoracoscopy for mesothelioma.
If the thoracoscopy is being done as an outpatient procedure (meaning you aren’t staying in the hospital overnight), you’ll get local anesthesia to numb the surgery site. You’ll be awake during the entire process.
If you’re getting it done as an inpatient procedure), your doctors will administer general anesthesia so you’ll be asleep during the surgery.
2. Doctor Drains Pleural Effusion
Many mesothelioma patients experience malignant pleural effusions (fluid buildup in the lung lining). Surgeons drain these effusions so they can access the pleural space.
This also reduces symptoms caused by the effusions, like shortness of breath and chest pain.
3. Pleural Space Gets Flushed With Air
The thoracic surgeon introduces a small amount of air into the pleural space to separate the lung from the chest wall.
This improves visibility for the surgeon without damaging the lung.
4. Doctor Inserts Thoracoscope and Removes Samples
A thoracoscope is inserted through a small incision in your chest, allowing the surgeon to examine the area and take tissue samples for a pleural biopsy.
5. Remaining Fluid Gets Drained
Any fluid collected during the procedure is drained to prevent discomfort and potential complications. A small tube may be left temporarily to continue draining fluid, which will be removed once drainage slows.
Already have a specialist? Bring our Free Doctor Questions Checklist to your next appointment and get answers about procedures like a thoracentesis.
Recovering From Thoracoscopy Surgery
Recovery from a thoracoscopy is usually quick. Many patients can go home the same day.
If you need to stay in the hospital, your chest tube will remain in place to drain excess fluid. You might receive supplemental oxygen as well. Both of these help ensure your lungs are functioning properly. You can typically go home in a few days.
You may need to avoid strenuous activities for a few weeks and follow the doctor’s instructions so the surgery site heals properly.
Risks & Side Effects of Mesothelioma Thoracoscopy
A thoracoscopy is minimally invasive and has a lower complication rate than other surgical procedures. That said, you could potentially develop side effects or complications.
Common side effects include:
- Bruising, swelling, or pain around the incision area
- Infection, including fever, increased pain, or discharge from the surgery site
- Shortness of breath or a cough
Be sure to report any side effects of mesothelioma thoracoscopy to a doctor immediately. They can recommend ways to manage them.
Benefits of Thoracoscopy for Mesothelioma
A thoracoscopy is one of the most effective procedures to diagnose pleural mesothelioma and help patients get the care they need. Learn about the benefits of a thoracoscopy.
Confirming a Pleural Mesothelioma Diagnosis
Thoracoscopy is an incredibly accurate test to diagnose pleural mesothelioma.
Mesothelioma thoracoscopies were more than 90% accurate, according to a review of over a dozen studies published in 2021.
Determining Mesothelioma Stage
A thoracoscopy allows doctors to determine the mesothelioma stage by seeing how the cancer has spread through the pleural cavity and other body parts like lymph nodes, the mediastinum, and the diaphragm.
Easing Painful Symptoms
Doctors can use thoracoscopy surgery to ease chest pain and other symptoms caused by pleural effusions.
A thoracoscopy helps reduce discomfort and improve quality of life by draining these fluid buildups.
“Most of the time when we’re doing surgery, patients have some degree of pain, and when we do some surgeries, particularly for biopsies or palliation, in a minimally invasive or thoracoscopic way, we can have less pain.“
Mesothelioma Cell Type
There are three mesothelioma cell types. Which type you have can impact your prognosis (overall health outlook), as some cells are easier to treat than others.
A doctor may take multiple biopsy samples with a thoracoscopy to help correctly diagnose your cell type.
Helping to Treat Mesothelioma Patients
Doctors may use a thoracoscopy to help provide mesothelioma treatments and assess how patients respond to them.
A thoracoscopy allows doctors to:
- Administer heated chemotherapy: Thoracoscopy allows doctors to deliver hyperthermic intrathoracic chemotherapy (HITHOC) into the chest cavity after surgery, targeting remaining cancer cells.
- Debulk tumors: A thoracoscopy can sometimes be used to remove portions of the tumor through debulking (partial pleurectomy), reducing its size and making other treatments more effective.
- Plan radiation therapy: Images from a thoracoscopy help doctors deliver precise radiation doses, minimizing damage to healthy tissues.
- See how the cancer responds: Thoracoscopy helps assess if tumors are shrinking from treatments. Doctors can also use a thoracoscopy and imaging tests like CT scans during follow-up visits to check for recurrence (where cancer comes back).
The potential use of thoracoscopy surgery in your treatment plan will be tailored to your diagnosis, cancer stage, and cell type.
Use our Free Doctor Match to find local specialists who can recommend treatments to help you live longer.
Research on Mesothelioma Thoracoscopy
Doctors continue to study how thoracoscopy can help patients in clinical trials for mesothelioma.
Notable mesothelioma thoracoscopy clinical trials include:
- IMPALA study (ongoing): Doctors use VATS to administer photodynamic therapy to treat pleural mesothelioma. Following this, patients receive an injection of the immunotherapy drug Opdivo® (nivolumab). Results are expected in 2026.
- PROSPECT study (ongoing): Researchers are cataloging any symptoms or side effects that patients develop from a thoracoscopy and any other procedures used to drain pleural effusions.
- University of Liege study (2020): In this trial, doctors performed probe-based confocal laser endomicroscopy (pCLE) after reaching the pleura using a thoracoscopy. The pCLE technique allowed doctors to see the cells in the pleura and determine if they were cancerous or not.
You may also qualify to join a mesothelioma clinical trial and get access to cutting-edge therapies. Contact us today for help finding trials near you.
Learn If Thoracoscopy for Mesothelioma Is Right for You
A mesothelioma thoracoscopy can not only diagnose this cancer but also ease your symptoms and be used to deliver potentially life-extending treatment.
Work with Mesothelioma Hope to connect with top specialists who can use thoracoscopy and other advanced techniques to diagnose and treat your cancer.
With our team’s help, you can:
- Better understand how a thoracoscopy may benefit you
- Match with mesothelioma doctors in your area
- Explore financial resources to help cover medical expenses
Call (866) 608-8933 to speak with our Patient Advocates and get started.
Thoracoscopy Surgery for Mesothelioma FAQs
Is thoracoscopy a major surgery?
No, a thoracoscopy for mesothelioma is not a major surgery.
In many cases, it’s performed as an outpatient procedure, meaning you could return home the same day.
Why would someone need a thoracoscopy?
You may need a thoracoscopy if doctors believe you have pleural mesothelioma or another cancer that’s invaded the lining of the lungs.
A thoracoscopy is often the best way to diagnose pleural mesothelioma since it allows doctors to get inside the lung lining and remove a sample for testing. Other tests like a needle biopsy may not be as accurate.
It can also drain painful fluid buildup called pleural effusion and be used to administer treatments that could help you live longer.
Contact us now to learn about mesothelioma thoracoscopies and other methods to diagnose and treat your cancer.
What is the difference between thoracoscopy and thoracotomy?
Thoracoscopies and thoracotomies both allow doctors to see inside of the chest area and remove a biopsy sample.
- A thoracotomy is a much more intensive surgery, as doctors must make a big incision in your back to reach areas like the lungs and chest wall. It can also be used to remove cancer tumors.
- When confirming a mesothelioma diagnosis, doctors typically prefer a thoracoscopy since the incision is smaller and patients can recover faster.
How risky is a thoracoscopy?
A thoracoscopy for mesothelioma is very low risk since it only involves a small incision. Many patients go home the same day they get a thoracoscopy.
Thoracoscopies can sometimes lead to complications, such as infection. Be sure to report any possible side effects like fever or drainage from the surgery site to your medical team right away.
How long does it take to recover from a thoracoscopy?
Most patients can quickly recover from mesothelioma thoracoscopies. According to Cleveland Clinic, you can start routine activities in 2 weeks and will fully recover in 4-6 weeks.
Those who receive it as an outpatient treatment can recuperate at home. If it’s done as an inpatient procedure, you may need to stay in the hospital for several days.
Your mesothelioma doctor can give you a better idea of how long it will take for you to recover.
Can a mesothelioma thoracoscopy help determine cell type?
Yes. Doctors remove a biopsy sample through a thoracoscopy so a pathologist (a specialist who studies cells) can see which cancer cells, if any, are present. The pathologist can then determine the specific histological (cellular) makeup of a mesothelioma tumor.
There are three main mesothelioma cell types: epithelioid, sarcomatoid, and biphasic. Most mesothelioma patients have the epithelioid cell type, which is the easiest to treat.
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