Diagnostic

Diagnostic mesothelioma surgery is one of three surgical options used in association with the treatment of mesothelioma cancer. Diagnostic surgery plays an integral role in providing a definitive mesothelioma diagnosis, making it one of the first steps on the road to treatment.

Among the mesothelioma diagnostic surgery types are five commonly used procedures:

Biopsy
Thoracoscopy
Video-assisted thoracic surgery (VATS)
Mediastinoscopy
Laproscopy

Regardless of the specific type of diagnostic surgery a patient might have to endure, it is typically a far less invasive experience than either palliative or curative surgical procedures because it is only used for the purpose of diagnosing disease. Whereas palliative and curative surgeries are used for the treatment of previously diagnosed diseases, diagnostic surgeries are used as a method of disease discovery.

Biopsy

A biopsy is a type of diagnostic surgery that involves the removal of a section of suspect tissue for the purpose of histopathological examination. The removal of a small section of tissue is called an incisional biopsy or core biopsy. If a larger section of tissue is removed for the purpose of examination, the procedure is called an excisional biopsy. Excisional biopsies are common if the tissue in question is a part of a small tumor like a mole.

Tissue removed during a biopsy is given to a histopathologist (expert in the study of diseased tissue) who performs a microscopic examination aimed at providing a definitive disease diagnosis. In the case of malignant mesothelioma, histopathologists are able to type the disease (pleural, peritoneal or pericardial mesothelioma) in addition to determining an approximate survival time and appropriate course of treatment.

Thoracoscopy

Thoracoscopic surgery is a type of diagnostic surgery that enables a doctor to examine the inside of the chest using a videoscope. Thoracoscopy can be more effective in determining a definitive disease diagnosis than standard methods of chest imagery; in fact, thoracoscopic surgery provides a definitive diagnosis approximately 98% of the time.

Thoracoscopic surgery is performed using a thoracoscope, a type of endoscopic instrument that allows for visual examination of the interior of a hollow organ or body canal. Thoracoscopy is a less invasive surgical procedure than an open biopsy; however, it cannot be performed if tumor cells have closed the pleural space.

Video-Assisted Thoracic Surgery (VATS)

A VATS diagnostic surgical procedure is somewhat similar to thoracoscopic surgery in that it uses a video device to view the pleural space and remove tissue samples for histopathological examination. The difference between thoracoscopy and VATS is that the latter is a far more invasive type of procedure; this is of concern because the more invasive a surgical procedure is, the greater the chances are of leaking tumor cells outside their confines (tumor seeding), helping to spur metastasis.

In order for VATS to be performed, several small incisions are made in the chest. A small camera device is inserted through one incision while the surgeon's tools are inserted through the remaining incisions.

Mediastinoscopy

Mediastinoscopy is a type of diagnostic surgery that uses a lighted tube to aid in the investigation of the median partition of the thoracic cavity (mediastinum), an area located between the lungs. This procedure allows doctors to view the lymph nodes located in this area while removing tissue samples to check for cancer.

Laproscopy

Laproscopic diagnostic surgery procedures are used for mesothelioma patients whose cancer has penetrated through the muscle wall below the heart and lungs separating the chest from the abdomen (diaphragm). Laproscopy are typically preceded by chest imaging that shows that mesothelioma cancer has metastasized through the diaphragm.

Laproscopic surgery requires the use of a long, thin instrument called a laproscope. An incision is made in the navel through which the laproscope is inserted. The body is often pumped full of gas so as to afford the doctor a clearer look inside the abdominal and pelvic cavities.