Ask An Expert: Open Lung Biopsy

Content provided by the Faculty of the Harvard Medical School

Ask An Expert: Open Lung Biopsy

Question:

Why would an open lung biopsy be needed? What are the post-operative issues from this procedure?

Answer:

When a person has an abnormality on chest X-ray or chest CT scan, or has lung disease of unknown cause, a lung biopsy may be needed to make the diagnosis. For certain types of abnormalities, the biopsy can be performed with a needle inserted through the chest wall or by bronchoscopy, a procedure that allows a doctor to look inside the bronchial tubes and take lung samples.

An open lung biopsy is recommended if:

A fine needle biopsy or bronchoscopy has not or is unlikely to provide a definitive diagnosis.
There is a spot on the lung that is possibly cancer.
The person has a complex medical history and the doctors need the best possible specimen to make a diagnosis.

Today surgeons most often prefer to perform video-assisted thoracic surgery (VATS) when an open lung biopsy is needed. By using a thoracoscope, an instrument similar to the laparoscope used in abdominal and pelvic surgery, a much smaller incision can be made compared to an open lung biopsy by thoracotomy. Thoracotomy requires a large incision and separation of the ribs.

On rare occasions, VATS is not an option. Sometimes a surgeon starts with VATS and realizes that a larger incision is needed to successfully complete the procedure.

VATS offers patients less postoperative pain, quicker recovery with less time in the hospital, and slightly less risk of lung complications. Both VATS and thoracotomy are done under general anesthesia. Complications of both include pneumothorax (air trapped in the chest), bleeding, and infection, as well as complications related to the anesthesia.

Howard LeWine, M.D., is chief editor of Internet Publishing at Harvard Health Publications. He is recognized as an outstanding clinician and teacher and is a recipient of the Internal Medicine Teacher of the Year award at Brigham and Women's Hospital. Dr. LeWine continues to practice Internal Medicine; most recently he became a hospitalist after practicing primary care for over 20 years.

Print This

Last updated:	January 24, 2007

Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.

This information is not intended to replace the advice of a doctor. By using AOL Body, you indicate that you have read, understood, and agreed to our Terms of Service, Use of Content Agreement and AOL Body Advertising Policy. Read more about our content partners.