Pace. Thoracoscopy can be used for visualization (pleuroscopy) or for surgical procedures. viagra time span Surgical thoracoscopy is more commonly referred to as video-assisted thoracoscopic surgery (vats). Pleuroscopy can be done with the patient under conscious sedation in an endoscopy suite, whereas vats requires general anesthesia and is done in the operating room. Both procedures induce a pneumothorax to create a clear view. viagra 20 mg walmart Thoracoscopy is used to evaluate exudative effusions and various pleural and lung lesions when noninvasive testing is inconclusive. The diagnostic accuracy for malignant and tuberculous disease of the pleura is 95%. The procedure is also used for pleurodesis in patients with recurrent malignant effusions and to break up loculations in patients with empyema. Indications for vats include correction of spontaneous primary pneumothorax, bullectomy and lung volume reduction surgery in emphysema, wedge resection, and, in some medical centers, lobectomy and even pneumonectomy. viagra for sale Less common indications are excision of benign mediastinal masses; biopsy and staging of esophageal cancer; sympathectomy for severe hyperhidrosis or causalgia; and repair of traumatic injuries to the lung, pleura, and diaphragm. Contraindications: contraindications are the same as those for thoracentesis; adhesive obliteration of the pleural space is an absolute contraindication. Biopsy is contraindicated in patients with highly vascular cancers, severe pulmonary hypertension, and severe bullous lung disease. generic viagra without prescription Procedure: although some pulmonologists do pleuroscopy, vats is done by thoracic surgeons. viagra samples Both procedures are similar to chest tube insertion; a trocar is inserted into an intercostal space through a skin incision, through which a thoracoscope is inserted. ordering viagra from canada Additional incisions permit the use of video cameras and accessory instruments. After thoracoscopy, a chest tube is usually required for 1 to 2 days. viagra 20 mg walmart Complications: complications are similar to those of thoracentesis. Postprocedural fever is common (16%); pleural tears causing air leak, subcutaneous emphysema, or both are less common (2% each). buy viagra usa Hemorrhage, lung perforation, and gas embolism are serious but rare. generic viagra overnight shipping Last full review/revision june 2009 by n. yahoo email hacked viagra