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Wednesday, March 10, 2021

Types of Thoracic surgery by Nursesnote

 Thoracic Surgery

Exploratory thoracotomy

Description: Internal view of lungs

  • Usually posterolateral parascapular but could be anterior incision.
  • Chest tube after procedure.

  • May be used to confirm carcinoma or for chest trauma ( to detect source of bleeding).

Description: Lobe removal

  • Thoracotomy incision at site of lobe removal
  • Chest tube after procedure.

  • Used when pathology is limited to one area of lung: bronchogenic carcinoma, giant emphysematous blebs or bullae, benign tumors, metastatic malignant tumors, bronchiectasis and fungal infections.

Description: Removal of an entire lung

  • Posterolateral or anterolateral thoracotomy incision
  • Sometimes there is a rib resection.
  • Normally no chest drains or tubes because fluid accumulation in empty space is desirable.

  • Performed chiefly for carcinoma, but may be used for abscesses, bronchiectasis, or extensive tuberculosis. Right lung is more vascular than left; may cause more physiologic problems if removed.

Description: Only certain segment of lung removed.

  • Segments function as individual units.

  • Used when pathology is localized ( such as in bronchiectasis) and when the patient has preexisting cardiopulmonary compromise.
Wedge resection

Description: Small localized section of lung tissue removed usually pie-shaped.

  • Incision made without regard to segments
  • Chest tubes after procedure.

  • Performed for random lung biopsy and small peripheral nodules.
  • Considered when less invasive tests have failed to establish a diagnosis.
  • May be used as a therapeutic procedure.

Description: Direct visualization of pleura with thorascope via an intercostal incision.

  • Medical under sedation or local anesthesia; allows for visualization and biopsy.
  • Video assisted thorascopic surgery (VATS) under general anesthesia; multiple puncture sites and video screen allow for visualization and manipulation of the pleura, mediastinum, and lung parenchyma.

  • VATS may be used for lung biopsy, lobectomy, resection of nodules, repair of fistulas.

Description: Removal or stripping of thick fibrous membrane from visceral pleura.

  • Use of chest tube drainage system postoperatively

  • Empyema unresponsive to conservative management
Thoracotomy not involving lungs

Description: Incision into the thoracic cavity for surgical procedure on other structures.


  • Used for hiatal hernia repair, open heart surgery, esophageal surgery, tracheal resection, aortic aneurysm repair.
Lung volume reduction surgery (LVRS)

Description: Involves reducing lung volume by multiple wedge excisions or VATS.


  • Performed in advanced bullous emphysema, ∝1-antitrypsin emphysema.

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