An open pleural biopsy is a procedure to remove and examine the tissue that lines the inside of the chest. This tissue is called the pleura.

Biopsy - open pleura

An open pleural biopsy is done in the hospital using general anesthesia, which means you are asleep and do not feel pain during the surgery. A tube will be placed down your throat to help you breathe.

The surgeon will make a small cut in the left or right side of the chest.

• The ribs are gently separated and a piece of tissue is taken from the chest area.
• Several pieces of tissue are usually taken, and are sent to a laboratory for examination.
• After surgery, the wound is closed with stitches.
• Your surgeon may decide to leave a small plastic tube in your chest to prevent air and fluid from building up

Today, most centers use a technique called video-assisted thoracoscopy, which uses a camera and tiny instruments to biopsy the pleural area. With this method, only two small cuts are made. There is less pain and the recovery is much faster.

You will be asked not to eat or drink for 8 hours before the test.

You will be asleep during the procedure. There will be some tenderness and pain where the surgical cut is located. Most surgeons inject a long-acting local anesthetic at the surgical cut site so that you will have very little pain afterwards.

You may have a sore throat after the test due to the breathing tube. You can ease the sore throat by eating ice chips.

This procedure is used when the surgeon needs a larger piece of tissue than can be removed with a pleural needle biopsy. The test is most often done to rule out mesothelioma.

It is also performed when there is fluid in the chest cavity, or when a direct view of the pleura and the lungs is needed.

This procedure may also be done to examine a metastatic pleural tumor.

The pleura will be normal.

Abnormal findings may be due to:

• Abnormal tissue growth (neoplasms)
• Disease due to a virus, fungus, or parasite
• Mesothelioma
• Tuberculosis

There is a slight chance of:

• Air leak
• Excess blood loss
• Infection
• Injury to the lung
• Pneumothorax

Putnam JB Jr. Lung, Chest Wall, Pleura, and Mediastinum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 58.