Instrumental_Diagnostic_Studies_Of_Thoracic_Surgery_Operations_on.pptx

Chest X-ray: Often the first imaging technique used to identify abnormalities such as tumors, fluid accumulation, or structural changes.

Computed Tomography (CT) Scan: Provides detailed cross-sectional images of the chest and is used to evaluate tumors, metastases, and other conditions.

Magnetic Resonance Imaging (MRI): Used less frequently than CT but can be useful for assessing soft tissue structures and certain types of tumors.

Positron Emission Tomography (PET) Scan: Often used in conjunction with CT to evaluate metabolic activity and identify cancerous tissues.

Bronchoscopy: A procedure where a flexible tube is inserted through the nose or mouth to examine the airways and collect tissue samples.

Thoracoscopy: A minimally invasive procedure using a small camera inserted through small incisions in the chest to view and sometimes biopsy the thoracic cavity.

Ultrasound: Can be used to guide needle biopsies or assess pleural effusions and other fluid collections.

Each of these techniques provides valuable information that helps guide

1. Instrumental Diagnostic Studies Of Thoracic Surgery. Operations on the Chest. By Wakib Amin Mazumder, NSMU Group - 17

2. SCT (Spiral Computed Tomography): This imaging technique uses X-rays to create detailed cross-sectional images of the chest. It's helpful in diagnosing various thoracic conditions such as tumors, infections, and pulmonary embolisms. SCT With Contrast: Similar to regular SCT, this procedure involves the injection of a contrast dye into the bloodstream to enhance the visualization of blood vessels and abnormalities. It's particularly useful in evaluating vascular structures and detecting thoracic tumors .

3. 3) FBS (Flexible Bronchoscopy): This involves inserting a thin, flexible tube with a camera (bronchoscope) through the nose or mouth into the airways to visualize the trachea and bronchi. It helps in diagnosing conditions like tumors, infections, and foreign body aspirations. The bronchoscope will be placed into either the nose or the mouth, then advanced slowly down the back of the throat, through the vocal cords and into the airways. Some people have an urge to cough or feel a sensation of wanting to catch their breath. If there is significant discomfort, more anesthesia can be given.Once the bronchoscope has passed between the vocal cords, it is difficult to speak normally. This can be frightening, but it is expected and resolves when the bronchoscope is removed. Oxygen levels are monitored at all times to be sure you are getting enough air.

4. 4) FGDS (Fiber-optic Gastro-Duodenoscopy): Although primarily used for examining the upper gastrointestinal tract, FGDS can sometimes be employed in thoracic surgery to investigate conditions such as esophageal disorders and hiatal hernias.

5. 5) Videothoracoscopy : Also known as thoracoscopy or VATS (Video-Assisted Thoracic Surgery), this minimally invasive procedure involves inserting a thoracoscope (a small camera) and surgical instruments through small incisions in the chest wall to examine and operate on the lungs, pleura, or mediastinum.

6. 6) Transthoracic biopsy: This involves using a needle to extract a tissue sample from the lung or other thoracic structures for examination under a microscope. It's often performed under imaging guidance such as CT or ultrasound to target specific lesions or abnormalities.

7. Operations on the Chest

8. Lung Resection This surgical procedure involves the removal of a portion or the entire lung to treat conditions such as lung cancer, lung infections, or severe lung damage. How is a lung resection performed? Traditionally, lung resections were performed using open surgery through the chest wall, which required a large incision and lengthy recuperation. Advances in robotic surgery technology have now made it possible to perform these procedures using minimally invasive surgery techniques. This significantly reduces the size of the incision our surgeons make, as well as reduces patients’ pain, length of hospitalization, recuperation time, and risk of infection.

9. There are five types of lung resection: • Wedge resection: Removal of a wedge-shaped section of diseased or damaged lung tissue. • Segmentectomy: Removal of one to four portions of a lobe of the lung while preserving the remaining portion. • Lobectomy: Removal of one lobe of your lung. • Bilobectomy: Removal of two lobes of the right lung while preserving the remaining lobes. • Pneumectomy: Surgeons remove your entire lung.

10. 2. Thoracotomy : A thoracotomy is a surgical incision made into the chest wall to access the thoracic cavity. It allows surgeons to perform various procedures such as lung resections, tumor removals, biopsies, or repair of chest injuries. Thoracotomies can be performed for both diagnostic and therapeutic purposes. A thoracotomy is performed under general anesthesia. An epidural catheter may be inserted in the mid-back before surgery for pain management. Once asleep, a breathing tube is placed into the airway to allow each lung to be separately inflated during surgery. You are then positioned on your side. An approximate six-inch incision is made below the tip of the shoulder blade, typically between the fifth and sixth ribs. During the surgery, the doctors will insert a chest tube on the side of the thoracotomy, which drains excess fluid or air leaking into the chest and helps your lungs to re-inflate. This tube remains in place for a few days

11. Possible risks from thoracotomy include: • infection • bleeding • air leaking from your lungs • pneumonia • blood clot in your leg (deep vein thrombosis) that can travel to a lung and cause a blockage (pulmonary embolism)

12. 3. Sternotomy : This surgical procedure involves making an incision through the sternum (breastbone) to access the organs and structures within the thoracic cavity, particularly the heart and major blood vessels. Sternotomy is commonly performed for open-heart surgeries such as coronary artery bypass grafting (CABG), valve replacement, or repair of congenital heart defects. A sternotomy allows a surgeon to get to areas under your sternum and ribs, such as • Heart. • Aorta. • Pulmonary arteries.

13. During sternotomy, surgeon will: 1 Cut through your skin with a scalpel, starting between your two collarbones. This is the top of your sternum. They’ll cut down to where your sternum ends. Your sternum is about 6 inches long if you’re an adult. 2 Cut through the middle of your sternum with a sternal saw from top to bottom. 3 Put in a tool (retractor) to move your split sternum apart. 4 Possibly remove part or all of your thymus gland if you’re a child (for better visibility). 5 Open your pericardium, the sac around your heart. 6 Access your heart through the opening in your pericardium. 7 Perform surgery on your heart or another body part in that area. 8 Close your sternum with eight to 12 sternotomy wires. If your bone is too hard for a needle to get through, your provider may use a drill to make small holes for the wires to go through. 9 Close your chest tissues and skin. 10 Put antibiotic ointment on your wound.

14. 4. Transthoracic puncture : Also known as percutaneous thoracentesis or needle biopsy, this procedure involves inserting a needle through the chest wall into the pleural space (the space between the lungs and the chest wall) to drain excess fluid or to obtain a tissue sample for diagnostic purposes. It's often used to diagnose and treat conditions such as pleural effusion or to collect samples for cytology or microbiological analysis. Risks of Transthoracic needle biopsy: Collapsed lung Pain during procedure Bleeding Missing the Nodule

15. 5. Drainage of the pleural cavity : This procedure involves the insertion of a chest tube (thoracostomy tube) through the chest wall into the pleural cavity to drain accumulated fluid or air. It's commonly performed to treat conditions such as pneumothorax (collapsed lung), hemothorax (blood in the pleural cavity), or pleural effusion (accumulation of fluid in the pleural space). Drainage of the pleural cavity helps re-expand the lung and relieve symptoms associated with these conditions. Thoracentesis is a procedure that a provider uses to drain extra fluid from around the lungs (pleural space) with a needle. It’s used to test the fluid for infection or other illnesses and to relieve chest pressure that makes it tough to breathe.