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Advanced Procedures for Diagnosing Mesothelioma

There are several instances in which minimally invasive procedures are not able to detect mesothelioma cancer.

For example, the combination of scans such as CAT scans, an MRI or PET scan and a needle biopsy may be insufficient to diagnose malignant mesothelioma. Sometimes, a CAT scan shows that the fluid is hidden in areas that would be very difficult to reach with a needle biopsy. Other times, an initial thoracentesis may not reveal cancer cells, but your medical team may still believe you are at serious risk for the disease. And sometimes, fluid removed during thoracentesis or paracentesis builds up again and needs additional treatment.

In these cases, if your medical team is concerned about mesothelioma, they may recommend a thoracoscopy or peritoneoscopy, depending on the area of concern.


During a thoracoscopy, the surgeon makes a one-inch incision in the chest between two ribs. The doctor then inserts a thin lighted tube, called an endoscope or thorascope, which sometimes has a camera on the end, to look into the chest cavity. If the doctor sees any abnormal tissue, he or she will cut out a very small piece of it; this process is called a biopsy. A pathologist will then examine the tissue under a microscope to determine if you have pleural mesothelioma.

A thoracoscopy also helps your doctor to determine where the disease is located and can also determine the status of the lung.

Video-Assisted Thoracic Surgery (VATS)

In this procedure, surgeon uses two to four small incisions (less than one inch in diameter) between the ribs to view the pleural space with a tiny video camera that projects and enlarges the image of the patient’s internal organs on a television screen. The doctor also obtains tissue samples for the pathologist to analyze.

This also helps the doctor diagnose and treat fluid around the lung and heart and determine where the disease is located.


The surgeon uses a thin lighted tube called a laparascope or peritoneoscope to examine the abdominal cavity and to remove (biopsy) abnormal tissue for analysis by a pathologist.

Open biopsy

If a thoracoscopy shows there is more solid tumor than fluid, a larger incision, about three or four inches long, is required at the side of the chest to remove a portion of the thickened pleura for biopsy. This should be performed by a thoracic surgeon (a surgeon who specializes in treating the lung and heart). A pathologist should also be in the operating room to be sure the surgeon has removed enough tissue for thorough testing.

If the diagnosis is mesothelioma, a patient is often given radiation treatments after these procedures to prevent the cancer from growing at the biopsy sites.

Doctors at the leading cancer treatment hospitals are most likely to be aware of the latest treatments and procedures for diagnosing and treating malignant mesothelioma. It’s always a good idea to seek out the best treatment you can find.

It’s also important to seek out the best legal help. You should know your legal rights. Our mesothelioma attorneys at Williams Hart have helped thousands of people who suffer from this asbestos-related disease, and for their families, so contact us today to find out if a mesothelioma lawsuit is appropriate in your situation. You deserve the best care and the best legal help. Not only will we do our best to help you recover money to pay for your treatment and for your pain and suffering, but you don’t pay us unless we recover money for you. Call us today.

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