thoracoscope

A thoracoscope is a medical instrument used to visualize the pleural space and thoracic cavity. It is a slender rigid or semirigid tube with an optical system and a light source at the tip, and it often includes one or more channels for passing surgical instruments. Modern thoracoscopes are commonly used as part of video-assisted thoracic surgery (VATS), in which the thoracoscope provides a view of the chest interior on a monitor.

Indications for thoracoscopy include diagnostic pleuroscopy to evaluate pleural disease or undiagnosed chest symptoms, biopsy of the pleura, lung, or mediastinal structures, and assessment of pleural effusions or pneumothorax. Therapeutic uses encompass drainage of effusions and empyema, pleurodesis to prevent recurrent effusions, decortication, and other limited thoracic procedures performed through small ports.

Technique generally involves general anesthesia with single-lung ventilation. The patient is positioned laterally or in a seated position, and small incisions are made to introduce the thoracoscope and additional instruments. The pleural space is visualized on a monitor, and CO2 insufflation may be used in some cases to aid exposure. Procedures can be performed through multiple ports or a single incision (uniport).

Risks and limitations include those common to thoracic surgery, such as infection, bleeding, air leaks, pneumothorax, and injury to lung, heart, or vessels. Not all conditions are suitable for thoracoscopy; extensive disease or poor exposure may necessitate conversion to open thoracotomy.

History and development note that thoracoscopy began as a diagnostic technique and evolved into modern VATS during the late 20th century, with ongoing instrumentation advances.