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[Rib cross thoracotomy for a huge thoracic lesion]
1Department of Thoracic Surgery, Hyogo Medical Center, Akashi, Japan.
Summary
Rib cross thoracotomy offers an improved operative field for extensive thoracic surgeries like panpleuropneumonectomy. This technique facilitates better visualization compared to standard lateral thoracotomy for complex thoracic procedures.
Area of Science:
- Thoracic Surgery
- Surgical Anatomy
- Operative Techniques
Context:
- Extensive thoracic surgeries, including panpleuropneumonectomy, thoracic tumor resection, and thoracic aneurysm repair, demand a wide operative field.
- Standard lateral thoracotomy incisions often provide insufficient exposure for these complex procedures.
Purpose:
- To describe the technique of rib cross thoracotomy for achieving an enhanced operative field in thoracic surgery.
- To provide a detailed procedural overview for surgeons undertaking extensive thoracic operations.
Summary:
- The rib cross thoracotomy involves incising the 6th, 7th, 8th, and 9th ribs at the midaxillary line, removing a 1 cm segment from each edge, and resecting the posterior half of the 6th rib.
- The thoracic cavity is accessed posteriorly at the 5th intercostal space, extending caudally to the 9th rib in the axillary line and anteriorly at the same intercostal space.
- This technique requires the use of two rib expanders to maintain the surgical field.
Impact:
- Provides a significantly larger operative field compared to conventional thoracotomy.
- Facilitates complex thoracic procedures by improving surgical access and visualization.
- Enhances surgeon's ability to manage large thoracic tumors and complex aortic aneurysms.