Practical Thoracoscopy

Diseases of the pleura such as effusion, thickening, or pneumothorax are frequently encountered in the practice of medicine. Practical Thoracoscopy presents an encyclopedic approach to the use of thoracoscopy in the diag nosis and treatment of patients with pleural disease. After an initial chapter on the history of thoracoscopy, the next three chapters of the book are devoted to the general technique of performing thoracoscopy, a topic on which the team of Dr. Boutin and his colleagues write with ample experience. In these chapters they provide detailed de scriptions of how to perform the procedure and discuss the pros and the cons of the different approaches and the different equipment available. The following chapter discusses the complications of the procedure. The next chapter discusses the role of thoracoscopy in diagnosing pleu ral effusions. My own opinion here is in general that, as long as well trained personnel are available, thoracoscopy is preferable to open pleural biopsy, because it is associated with less morbidity and mortality and can be done if necessary under local anesthesia. The following chapter is directed at using to thoracoscopy to facilitate pleurodesis for chronic pleural effusions. With Boutin's method, talc pou drage is performed during thoracoscopy, and certainly, if a thoracoscopy is used to establish the diagnosis of a malignant pleural effusion, it is appro priate to attempt to induce a pleurodesis with talc at the time of the diag nostic procedure.

There is an increasing need for medical thoracoscopy performed by pulmonologists, which may be video assisted and has the advantage of being very cost-effective. This book is a comprehensive and up-to-date guide to thoracoscopy for pulmonologists that documents the considerable progress in endoscopic telescopes and instrumentation. Clear practical guidance is provided on technique, and diagnostic, therapeutic, and interventional applications of thoracoscopy are all carefully examined with the aid of high-quality illustrations. Although medical thoracoscopy is much less invasive than thoracotomy, complications can occur in a small number of cases; these are discussed and advice on prevention is provided. The concluding section examines the future of the field, covering developments such as ‘mini’ thoracoscopy, autofluorescence thoracoscopy, and flexi-rigid thoracoscopy.

Thoracoscopy and biopsy have developed as indispensable tools to diagnose pleural, and sometimes lung, disease when simple clinical and laboratory methods of examination have failed to yield a diagnosis. Thoracoscopy is most often undertaken by surgeons, but may also be performed by trained physicians. It takes place in an endoscopy or operating room using simple sedation, local anaesthesia and non-disposable equipment, and is a useful, less invasive alternative to thoracotomy. Direct visualisation of the pleura with the thoracoscope achieves a diagnosis in approximately 95% of patients with tuberculosis or malignancy because biopsies are taken from areas seen to be macroscopically abnormal. Despite these advantages, the technique has until recently been vastly under-used in the UK when compared to practice in Europe and North America. This is now changing, however, with interest in the technique rekindled in parallel with rapid advances in equipment technology. The time is therefore right for the publication of this unique clinical guide to thoracoscopic practice. The book demonstrates the diagnostic and therapeutic value of this technique, which can be undertaken under local anaesthesia in a district general hospital. In addition to its use in the diagnosis of pleural disease, thoracoscopy has valuable therapeutic applications with the concomitant instillation of talc or other sclerosing agents into the pleural cavity for pleurodesis. Concise, practical and readable, this volume covers the indications for thoracoscopic investigation of the thoracic cavity, and describes and illustrates the techniques involved, their contraindications and associated hazards. Useful for MRCP candidates and specialist registrars in thoracic medicine seeking accreditation, it is also a handy aide-memoir for the practicing respiratory physician.

A detailed guide to the latest endoscopic techniques in interventional pulmonology In Medical Thoracoscopy/Pleuroscopy: Manual and Atlas, international experts explain the current methodology and demonstrate different technical approaches to medical thoracoscopy/pleuroscopy (MT/P) in the diagnosis and treatment of pleuropulmonary diseases. A combination of instructive manual and atlas, this book presents clinical cases with indications, techniques, and outcomes for each procedure. In the 'Atlas', endoscopic photographs demonstrate the application of this minimally invasive technique in various pathologies, from pleural effusion to various manifestations of lung cancer. Features: Diagnostic and therapeutic indications reflect new technology such as the semi-rigid/semi-flexible pleuroscope, CT/MR imaging, and video-assisted thoracoscopic surgery (VATS) Over 150 full-color endoscopic photographs and 120 figures enhance the text An accompanying DVD contains video clips of 8 typical clinical cases, plus practical information on the use of talc poudrage, the induction of a pneumothorax, and more This comprehensive visual guide is an indispensable primer for residents and fellows in pulmonology or pneumology, and for respiratory physicians, internists, or thoracic surgeons. System Requirements for the DVD: Language: English; region code: 0; picture format: 4:3 NTSC; duration: 33 minutes (approximately); disk format: DVD-5.

Extensively revised and expanded, Practical Thoracic Pathology: Diseases of the Lung, Heart, and Thymus (formerly Practical Cardiovascular Pathology) is a superbly illustrated, one-volume reference to pathology of the thorax. More than 1,000 full-color illustrations, tables, and “practical points” boxes help you arrive at a diagnosis accurately and efficiently. Ideal for both pathology residents and practicing surgical pathologists, this in-depth resource focuses on illustrated practical diagnosis, including differential diagnosis.

After a practical description of the endoscopic anatomy, the first part of the book deals with such topics as preparing and positioning the patient, anaesthesia, operation theatre layout and operating team, inducing pneumothorax, general operative steps, after-care in the hospital, prevention of thrombosis, prophylactic antibiotics, dangers and risks of the method, and the use of documentation. General operative steps such as thoracoscopic exploration and palpation intervention haemostasis andparenchymal leaks are described in a separate section. A special part isdevoted to the diagnostic possibilities and current indications for thoroscopy including: spontaneous pneumothorax, haemothorax, chylothorax; pleural empyema, bronchopleural fistula, extrathoracic and intrapulmonary cysts and tumours, pericardial fenestration, treatment of malignant effusions, and thoracal sympathectomy.

This book provides a comprehensive, practical and timely review of all aspects of video-assisted, minimally invasive thoracic surgery, used to treat conditions of the lung, pleura, mediastinum, chest wall and diaphragm. Advances in technologies and instrumentation mean almost all thoracic surgeries may be performed by minimally invasive techniques rather than the traditional open surgeries. This book describes the thoracoscopic procedures in current specialist practice with discussion on indications, patient selection, surgical approaches, complications and clinical outcomes. The book opens with a summary of the rationale for minimally invasive surgery and when to convert to open surgery, as well as anaesthetic and peri-operative considerations, before covering the range of procedures organised by anatomical site. Numerous figures and diagrams describe every technique in detail and an authoritative, international team of contributors provides clinical experience and expert guidance.

Written by some of the world's leading practitioners - and pioneers - in the field, Thoracic Endoscopy is the first up-to-the-minute, expert reference for clinicians with a solid foundation in diagnostic bronchoscopy and chest medicine needing to extend their clinical expertise in response to two decades of rapid development. Thoracic Endoscopy covers four key areas of practice: advanced diagnostic bronchoscopy the latest techniques for interventional bronchoscopy — including the traditional rigid bronchoscopy techniques, ablative instruments and stents — and a discussion of endobronchial lung reduction and gene therapy a window to the pleura, covering the field of pleuroscopy and the advances in diagnosis and treatment clinical problems and methodologies, and strategies for solving them using interventional techniques Thoracic Endoscopy presents the only coherent guide to the full range of techniques and practice patterns, and is the essential reference for both experienced interventional pulmonologists and students beginning to practice in this rapidly-developing field.

Small Animal Laparoscopy and Thoracoscopy provides a comprehensive reference to laparoscopy and thoracoscopy, with step-by-step guidance for surgical techniques ranging from basic to advanced. • Acts as both a quick reference to specific techniques and as a comprehensive resource to small animal laparoscopy and thoracoscopy • Guides the reader through each step of the surgical techniques • Takes a clinically oriented approach, with tips on safely and quickly performing procedures throughout • Part of the Advances in Veterinary Surgery series copublished with the American College of Veterinary Surgeons Foundation • Includes access to a companion website with video clips of the procedures described and the figures from the book in PowerPoint