Pleural Cavity Chest of Surgery
The pleural cavity is the space that lies between the pleura, the two thin membranes that line and surround the lungs.
Empyema is a collection of pus in between the lung and the inner surface of the chest wall (pleural space). Common causes for empyema are tuberculosis, pneumonia, penetrating chest injury, esophageal rupture, complication from lung surgery, or inoculation of the pleural cavity after needle aspiration or chest tube placement. Sometimes a peel forms over the lung surface and inner lining of chest which restricts the expansion of lung along with poor penetration of antibiotics. VATS decortication is required to remove all the pus from the chest cavity and the peel is completely removed to allow the lung to expand.
Drainage & control of Hemothorax
Hemothorax is when blood collects between the chest wall and the lungs. Most common cause of hemothorax is chest injury. Hemothorax is commonly treated by inserting a tube in chest cavity. Sometimes the blood is clotted or loculated or may get infected to form an empyema. These patients often need surgical drainage. We treat these patients by key hole surgery.
Thoracoscopy is recommended to establish a diagnosis in patients with undiagnosed pleural effusions. It allows direct visual assessment of the pleura and subsequent biopsy of visually abnormal areas, hence maximising diagnostic yield. Thoracoscopy may be performed either under general anaesthesia or under sedation with local anaesthetic. Pleurodesis can be undertaken during thoracoscopy if the pleura appears abnormal on direct inspection to prevent recurrence of pleural effusion.
Results from leakage of lymphatic fluid from thoracic duct. Thoracoscopic ligation of the thoracic duct provides a safe and effective treatment of chylothorax and may avoid thoracotomy and its associated morbidity.