Thoracoscopy for Physicians

Thoracoscopy and biopsy have been developed as critical tools with which to diagnose pleural, and sometimes lung, disease when simpler clinical and laboratory methods of examination have failed to yield a diagnosis. Thoracoscopy, which can be performed in an endoscopy suite or operating room, using simple sedation and local anaesthesia and non-disposable equipment, is a useful, and less invasive, alternative to thoracotomy. Direct visualisation of the pleura with the thoracoscope achieves a diagnosis in over 90% of patients with tuberculosis or malignancy because biopsies can be taken from areas that are 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 clearly the diagnostic and therapeutic value of this technique, which can be undertaken under local anaesthesia in any District General Hospital. 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, particularly junior doctors working in thoracic medicine and seeking accreditation, it is also a handy aide-memoir for the practicing respiratory physician.