A "conservative" method of thoracic wall dissection: a proposal for teaching human anatomy

Area of Science:

• Thoracic Surgery
• Surgical Anatomy
• Minimally Invasive Techniques

Background:

• Traditional thoracic dissection often involves extensive resection of chest wall muscles.
• Preservation of pectoral muscles is crucial for maintaining upper limb function and cosmetic outcomes.
• Existing methods may lead to significant morbidity and prolonged recovery.

Purpose of the Study:

• To present a novel, less demolishing technique for thoracic wall dissection.
• To describe a method that minimizes resection of pectoral muscles.
• To facilitate thoracic cavity entry while preserving key anatomical structures.

Main Methods:

• A technique involving transverse manubrium resection and 1st intercostal space incision.
• Elevation and preservation of pectoralis major and minor muscles.
• Resection of ribs from the 2nd to 10th, preserving intercostal muscles and serratus anterior as hinges.
• Median sternotomy from xiphoid process to manubrium resection.

Main Results:

• Successful entry into the thoracic cavity with significantly reduced pectoral muscle resection.
• The described technique allows the thoracic wall to be opened like 'shutters'.
• Preservation of muscle origins and insertions, potentially improving postoperative function.

Conclusions:

• The proposed technique offers a less demolishing approach to thoracic dissection.
• It effectively preserves pectoral muscles, potentially reducing surgical complications.
• This method represents a valuable alternative for thoracic surgeons seeking to minimize tissue disruption.