1. You will receive fluids and medication through an intravenous (IV) line.
2. You will receive general anesthesia by an anesthesiologist during the procedure so you will be asleep.
3. The anesthesiologist will insert a breathing tube to stop the function of the lung that is being treated.
4. The cardiac surgeon will make 1-4 small incisions, measuring 1-3 centimeters, in the spaces between the ribs. The number and position of the incisions will depend on the disease and the difficulty of the procedure.
5. The cardiac surgeon will carry out the treatment and/or remove a tissue sample for further analysis.
6. The procedure takes 2-3 hours.

You will stay in the hospital for 1-4 days after the procedure. When you wake up in the recovery room you will likely feel sleepy, confused, and thirsty. There will be an intravenous line in place to deliver fluids and medications. You will also be attached to equipment to measure your blood pressure and respiration. Please follow these instructions:

• Practice breathing as you are advised by a nurse or physical therapist to help your lungs expand properly and to prevent pneumonitis. Do your breathing exercises every hour.
• Nurses will support you in getting up and walking around as soon as possible after the procedure to encourage circulation and speed up recovery. If any drains are placed, they will need to be removed before you can go home.

• Infection
• Excessive bleeding due to injury to blood vessels
• Pneumothorax, perforation of lung tissue
• Pneumonitis
• Obstruction of blood vessels due to air bubble

You will need to recover at home for 1-2 weeks. If you have any questions, please talk to your doctor or medical team.

• Activity. Avoid activities that involve pulling or pushing, lifting heavy objects, and other strenuous activity. Avoid driving for 2-3 weeks as this can affect the incision. Avoid sexual intercourse until the incision is healed.
• Wound Care. When your doctor allows you to bathe, shower daily with soap. Dry the surgical wound well and keep it clean. Don’t apply any creams, lotions, or powders to the incision until it is fully healed and appears like normal skin. Please contact your doctor if the wound is inflamed or swollen, if the pain is worsening, or if the wound is leaking fluid or blood.
• Diet. Your diet should be restricted in accordance to existing medical conditions. Eat healthily to promote wound healing.
• Exercise. Practice breathing continuously. Avoid strenuous exercise for at least 1-2 weeks.
• Medication. If you are prescribed antibiotics, please take them until you finish them. Please take all medication as prescribed by your doctor.
• Appointments. Please keep all follow-up appointments so your wound can be monitored and stitches removed. If you experience any abnormal symptoms, such as fever, difficulty breathing, worsening fatigue, coughing blood, etc., please see your doctor before the scheduled appointment.

• You should plan to stay in Thailand for at least 2-3 weeks through the duration of your treatment.
• It is recommended that you stay in a hotel close to the hospital for convenience in traveling to the hospital before and after the procedure or from the day of the procedure to the day of your follow-up appointment.
• When traveling by air, if you are seated in Economy Class, please choose an exit row or bulkhead seat for convenience in getting up and moving around every 15-30 minutes. Flex your ankles regularly to prevent deep vein thrombosis.
• Please take all medication prescribed by your doctor. Carry the appropriate dosage of mediation in your carry-on luggage when you travel as well as a few extra doses in case of an emergency. Carry the prescription for all your medication to avoid problems at the airport.

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The success of the procedure depends on a number of factors. Please discuss the likelihood of success with your doctor before the procedure.
 
What if the procedure is not performed?
This procedure is used for the diagnosis/treatment of conditions related to the chest. If you choose not to undergo this procedure, carefully consider the pros and cons as well as limitations and risks of other diagnostic/treatment options.
 

Traditional open surgery—thoracotomy.