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Surgical Diagnosis of Chest, Lung Problems

You’ve been told you need a surgical procedure to diagnose a problem in your chest or lung. Surgical procedures are used to get large samples of tissue or lymph nodes from the chest or lung. These samples allow for more complete testing. Surgical procedures typically require incisions and may take some time to recover from.

 

Mediastinoscopy

Mediastinoscopy allows the doctor to see inside the mediastinum (area between the two lungs) and remove large lymph node samples (biopsy). First, an incision is made at the base of the neck. A scope is passed through the incision down into the mediastinum. Then a biopsy instrument is passed through the center of the scope. Once the lymph node sample is taken, the instrument is pulled up through the scope. The sample is then tested for cancer or other problems.

Video-Assisted Thoracic Surgery

Video-assisted thoracic surgery (VATS) allows the doctor to see inside the chest and take tissue samples. VATS is done using a thoracoscope (instrument with a light, lens, and camera). First, an incision is made on the side of the chest. The scope is passed through the incision into the pleural space (between the lungs and chest wall). Images of inside the chest are sent to a monitor viewed by the doctor. Other small incisions are made for instruments to pass through and remove tissue. VATS can also help diagnose and stage cancer.

Thoracotomy

In certain cases, open surgery is needed to diagnose and treat a lung or chest problem. If so, incisions are made and the chest is opened. This allows the doctor to see inside the chest and take a sample of lung tissue or a mass.

Preparing for the Procedure

Before your procedure, do the following:

  • Follow your doctor’s instructions about eating and drinking.

  • Tell your doctor about the medications you take. You may need to stop taking certain medications before the procedure, especially aspirin, Coumadin, or other blood thinners.

  • Discuss any allergies and health problems with your doctor.

  • Tell your doctor if you are pregnant.

During the Procedure

You receive general anesthesia (medication to make you sleep) during the procedure. Once you are asleep, incisions are made in the neck, chest, side, or back to allow the doctor to view the area or take a biopsy if needed. A tube placed in the chest during surgery drains fluid.

 

Risks and Complications

  • Hoarseness

  • Bleeding

  • Infection

  • Abnormal heart rate

  • Pneumothorax (collapsed lung)

  • Injury to other structures in the chest

  • Respiratory failure (rare)

  • Nerve damage

  • Death (rare)

 

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