[A device of intercostal thoracotomy for preparing an intercostal muscle flap]

A device of intercostal thoracotomy for preparing an intercostal muscle flap (IMF) is reported. In order to preserve a intercostal muscle (IM) at the level of thoracotomy, a thoracotomy is preformed by incision of lower edge of IM. By this technique, an intercostal thoracotomy can be performed with preservation of an IM. In a case with high risk of bronchopleural fistulas after pulmonary resection, this preserved IM can be easily used for preparing a muscle flap in order to wrap the bronchial stump or the anastomotic site of bronchoplasty. We have used IMF by this technique for 6 cases of lobectomy and 8 cases of bronchoplasty, which have high risk of postoperative bronchopleural fistulas. Of these 14 cases, there have been no postoperative bronchopleural fistulas, including the other complications. By this method of the intercostal thoracotomy with preservation of IM, IMF can be easily prepared without the use of other IMs, even when high risk of bronchopleural fistulas is newly anticipated after pulmonary resection. Therefore, the presented method of the intercostal thoracotomy is recommended for a routine thoracotomy.