Mesothelioma Surgery Types: Thoracentesis
One method of aspirating fluid for the purpose of diagnosing the cause of fluid build-up or relieving shortness of breath is thoracentesis. In mesothelioma patients, it can be performed either at bedside or as an outpatient. A chest x-ray is taken to show the location of the pleural fluid. However, an ultrasound and/or CT scan may also be ordered if the chest x-ray does not provide a definitive image, if previous thoracentesis procedures were unsuccessful, or if the fluid is trapped within layers of tissue.
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How Thoracentesis Is Performed
This mesothelioma surgery is typically performed with the patient sitting upright, bent slightly forward, with their arms resting on supports. But thoracentesis can be done on a patient who is lying down if it is guided by ultrasound or CT scan.
Before the procedure, the patient is injected with an anesthetic to desensitize the skin, and a needle with more anesthetic is then placed along the upper border of the rib below the location of the fluid. The needle is moved slowly deeper to avoid accidentally inserting it into a blood vessel, and the anesthetic is injected along the way. The parietal pleura, which is the part of the pleura that lines the chest wall, receives the most anesthetic. The needle is then moved past the parietal pleura until the pleural fluid is reached, and the depth of the needle at that time is recorded.
A thoracentesis needle with a catheter is then attached to a 3-way valve, and the valve is connected to a syringe and tubing for drainage. The thoracentesis needle is placed along the upper border of the rib into the pleural fluid at approximately the same depth that was previously recorded. The catheter is inserted into the fluid, and the needle is withdrawn so drainage can begin.
Florida Doctors Develop Curriculum to Teach Thoracentesis
In 2007, doctors from the Center for Patient Safety at the University of Miami, Jackson Memorial Hospital instituted a comprehensive approach to teaching hospital staff how to perform invasive procedures, one of which was thoracentesis.
Their curriculum was designed to improve patient safety and included such features as using an ultrasound to guide the doctor during the procedure, having the procedure supervised by staff members who are experts, using a team-based approach and employing a checklist to ensure all aspects of the procedure are properly implemented.
Side Effects of Thoracentesis Mesothelioma Surgery
The patient may begin coughing as the lung re-expands. If the pleura are inflamed, they may also experience pain and hear the sound of the pleural layers rubbing together as the fluid is drained. This is because the layers are so close together, having increased in size due to the inflammation.
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