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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 resuscitative thoracotomy is indicated when severe injuries within the thoracic cavity (such as hemorrhage) prevent the physiologic functions needed to sustain life.The injury may also affect a specific organ such as the heart, which can develop an air embolism or a cardiac tamponade (which prevents the heart from beating properly).
Video-assisted thoracoscopic surgery (VATS) is a type of minimally invasive thoracic surgery performed using a small video camera mounted to a fiberoptic thoracoscope (either 5 mm or 10 mm caliber), with or without angulated visualization, which allows the surgeon to see inside the chest by viewing the video images relayed onto a television screen, and perform procedures using elongated ...
VATS operations rely on a thorough understanding of pulmonary anatomy to allow for strategically placed incisions (usually 3–5 incisions total). The main advantages of VATS over thoracotomy are that major muscles of the chest wall are not divided and rib spreaders that can lead to rib fractures or costovertebral joint pain are not
This incision heals rapidly and generally has good cosmetic results, especially if a subcuticular suture is used to close the skin. [7] McEvedy's incision – McEvedy's original incision was a lateral paramedian incision which used to incise the rectus sheath along its lateral margin and gain access by pulling the rectus medially.
The technical name is a thoracotomy. A patient comes in unconscious, maybe in cardiac arrest, and Goldberg has to get into the cavity to see what is going on. With a scalpel, she makes an incision below the nipple and cuts 6 to 10 inches down the torso, through skin, through the layer of fatty tissue, through the muscles.
The results from VATS-based pleural abrasion are slightly worse than those achieved using thoracotomy in the short term, but produce smaller scars in the skin. [12] [15] Compared to open thoracotomy, VATS offers a shorter in-hospital stays, less need for postoperative pain control, and a reduced risk of lung problems after surgery. [15]
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