A thoracotomy is a procedure in which a surgeon enters the chest cavity for diagnostic or surgical purposes. Thoracotomy procedures may be used for other diagnostic reasons as well. Lung cancer is the most common reason for this surgery. A number of persons are diagnosed with lung cancer every year, making thoracotomies a common diagnostic and surgical intervention.
The most common reason for a thoracotomy is lung cancer. Removal of tumors or the lung itself can be performed using this procedure. Diagnostic testing of lung tissue or other organs located in the chest cavity may be utilized with this procedure.
A thoracotomy may include removal of a lung due to lung cancer or disease, or it may provide access to the heart and other internal organs located in the chest cavity. Thoracotomy surgery may also be used to provide resuscitative support in cases of chest injuries or trauma.
A thoracotomy procedure usually involves an incision placed on the side of the chest or under the arm or through the sternum. The location of the incision will be made depending on the reason for the surgery. The surgeon attempts to make the incision in an anatomical location to minimize muscle, nerve and bone disruption.
The incision is typically about five inches to ten inches long. The surgeon then places a tube into the trachea, or windpipe and one lung may be deflated to allow for greater room for inspection and surgical intervention.
For the procedure, the patient is positioned on his or her side with an arm raised. Muscle layers are then cut and a rib may be removed to allow greater access to the damaged potion of the lung or other internal organ.
Depending on the medical condition, one of the following may be performed
A pneumonectomy is the complete removal of one of the lungs from the chest cavity. This is usually the case with extreme trauma or lung cancer.
A segmentectomy would be performed when a section of lung requires removal, and allows the lung to remain in place.
A lobectomy removes one of the lobes or section of a lung. The right lung contains three lobes and the left lung contains two lobes. This procedure is usually a standard with lung cancer treatment.
After the thoracotomy is completed the chest wall is closed using staples, stitches or a combination of both. A hospital stay is usually required and a chest tube may stay in place for a few days to allow the affected lung (when left in the chest cavity) to return to full function.
A thoracotomy is an emergency procedure, and can therefore be performed by any medical professional with adequate training in the procedure. In most cases, the procedures is performed by emergency department personnel, including emergency doctors, residents, surgeons or other staff available when needed.
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