Thoracotomy

thoracotomy

1. Thoracotomy By kajal sansoya

2. What is T horacotomy ? It is process of making an incision into the chest wall. Performed by a surgeon , to gain access to the thoracic organs, most commonly heart, lungs and esophagus or thoracic aorta & sometimes to access the tumors in spine.

3. Purpose Thoracotomy allows to study the conditions of the lungs such as removal of lung or part of lung or removal of rib. Thoracotomy also provide access to heart , diaphragm and portions of aorta which passes through the chest cavity. Lung cancer is most common cancer requiring a thoracotomy . Tumors growth can be removed through the incision.

4. Approaches to T horactomy There are 3 main subtypes of thoracotomy incisions Posterolateral incision Anterolateral incision Axillary incision

5. Posterolateral It is a gold standard for access to the thorax. It provides access to all thoracic viscera, & is mainly used for pulmonary resections. It is very common approach for operations on lungs. When performed on 5 th intercostal space , it allows optimal access to pulmonary hilum ( pulmonary artery and pulmonary vein) Incision of choice for pulmonary resections i.e pneumonectomy & lobectomy .

6. Incision is made in patient in lateral decubitus position. It starts from between scapula and mid-spinal line and extends laterally to anterior axillary line. Before reaching thoracic cavity, incision is passed through latissimus dorsi & serratus anterior muscle then transects the rhomboids & tapezius .

7. Lateral decubitis position is an ideal position to perfome thoracotomy

8. Anterolateral Incision is made under breast. Incision can be used in a variety of operations for cardiac, pulmonary and oesophageal pathology. Left anterolateral thoracotomy is incision of choice for open massage. Incision runs from lateral border of sternum to the mid- axillary line at 4 th or 5 th intercostal space, dividing through the pectoralis major & serratus anterior in it approach.

9. Bilateral thoracotomy combine with transverse thoracotomy results in clamshell incision , the largest incision commonly used in thoracic surgery.

10. Axillary Axillary thoracotomy is a muscle sparing approach to the thoracic cavity used for pneumoectomy and pneumothorax operations. Incision is made on the side, under the arm , between posterior border of the pectoralis major & anterior border of latissimus dorsi muscles, through the 4 th and 5 th intercostal space.

11. Incision reduces muscle damage and has good cosmetic outcomes. Gave exposure to thoracic viscera. It is choice of incision in majority of PDA conditon and pulmonary resections conditions.

12. Thank you Happy reading 