5.3: Thoracoscopy and talc
Thoracoscopy and talc
This is a longer procedure (45-60min) and a more complex procedure. Sometimes this procedure is done under a general anaesthetic (patients are asleep) and sometimes it is done with sedation (patients are sleepy and relaxed but still awake). The doctor makes a small cut in the skin and makes a small tunnel down to the fluid. All the fluid is removed through a suction tube. When most of the fluid has been drained away, a dry powder of glue (a substance called ‘talc’) is then sprayed into the chest to try and stick the lung to the rib cage and prevent the fluid from coming back again. This is called ‘pleurodesis’. A chest drain is inserted at the end of the procedure to keep the chest cavity as dry as possible as the glue works. The drain stays in place for a few days before being removed which means spending those days in hospital.
Advantages
- Very good at relieving breathlessness caused by the fluid
- All the fluid is removed during the procedure (is not limited by a maximal volume that can be drained). This might offer the most immediate and maximal improvement in breathlessness
- Fluid removal and talc given in the same procedure which might reduce the overall time spent in Hospital
- Can stop the fluid from coming back in three quarters of cases
- It works as well as a chest drain and talc but usually requires a shorter stay in hospital
Disadvantages
- Need to stay in hospital for an average of 2-3 days
- The glue might not work and fluid could come back
- Longer and more intensive procedure
- Glue cannot work if the lung is trapped
- Sometimes, we only find out the lung is trapped after the procedure
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Will this be painful?
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The chest drain used in this procedure is a larger one and can cause some discomfort whilst the drain is there. Spraying glue into the chest can cause pain in some patients |
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Will I spend time in hospital?
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Requires a short stay in hospital – usually 2-3 days |
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Will I need to come back to hospital?
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If the glue works then future hospital visits will be minimal If the glue fails further hospital visits are very likely |
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Will I need further procedures?
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If the glue is successful then further procedures will not be needed If the glue fails further procedures are very likely |
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What if my lung is trapped
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The glue will not work if the lung is trapped This procedure should not be used in a trapped lung Sometimes, we only find out the lung is trapped after the talc & drain has been inserted and the fluid has been drained. |
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Where can this be done?
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Thoracoscopy is a specialised test that is performed at selected hospitals |
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Is there any aftercare?
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Once discharged from hospital there is no specific aftercare is needed |