How long does this procedure take? Lung decortication surgery takes more than two hours. The pieces have to fit through a small opening. This condition, known as pleural thickening or fibrosis, can restrict lung expansion and compromise breathing. This comprehensive article aims to provide an. Thoracoscopic decortication is really a a minimal access surgical procedure involving the surgical removal with the surface layer, membrane, or fibrous cover of lung. This peel develops in the pleural space, which is the area between the lung and the chest wall, and prevents the. Fibrothorax is a condition characterized by accumulation of fibrous tissue in the pleural cavity in reaction to undrained pleural fluid.