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A thoracotomy is a surgical procedure to gain access into the pleural space of the chest. [1] It is performed by surgeons (emergency physicians or paramedics under certain circumstances) to gain access to the thoracic organs, most commonly the heart, the lungs, or the esophagus, or for access to the thoracic aorta or the anterior spine (the latter may be necessary to access tumors in the spine).
A common complication after thoracic surgery that arises within 30–50% of patients are air leaks. If a chest tube clogs when there is an air leak the patient will develop a pneumothorax. This can be life-threatening. [12]
Thoracentesis / ˌ θ ɔː r ə s ɪ n ˈ t iː s ɪ s /, also known as thoracocentesis (from Greek θώραξ (thōrax, GEN thōrakos) 'chest, thorax' and κέντησις (kentēsis) 'pricking, puncture'), pleural tap, needle thoracostomy, or needle decompression (often used term), is an invasive medical procedure to remove fluid or air from the pleural space for diagnostic or therapeutic ...
MIDCAB differs from OPCAB in the type of incision used for the surgery; with traditional CABG and OPCAB a median sternotomy (dividing the breastbone) provides access to the heart; with MIDCAB, the surgeon enters the chest cavity through a mini-thoracotomy (a 2-to-3 inch incision between the ribs).
The procedure allows immediate direct access to the thoracic cavity, permitting rescuers to control hemorrhage, relieve cardiac tamponade, repair or control major injuries to the heart, lungs or thoracic vasculature, and perform direct cardiac massage or defibrillation. The procedure is rarely performed and is a procedure of last resort.
Chevron incision – This incision is a cut made on the abdomen below the rib cage. The cut starts under the mid-axillary line below the ribs on the right side of the abdomen and continues all the way across the abdomen to the opposite mid-axillary line thereby the whole width of the abdomen is cut to provide access to the liver.
The flap allows for 1) passive drainage of the pleural space and 2) negative pressure to develop in the thoracic cavity due to it being easier for air to escape than to enter the chest. The lung can then expand to the chest wall and seal the inner opening of the flap. [3] Other surgeons have subsequently proposed modifications to the procedure. [6]
Minimally invasive cardiac surgery, encompasses various aspects of cardiac surgical procedures (aortic valve replacement, mitral valve repair, coronary artery bypass surgery, ascending aorta or aortic root surgery) that can be performed with minimally invasive approach either via mini-thoracotomy or mini-sternotomy.