Postoperative Complications
Figure 49.1 Detection of a parenchymal fistula. To localize the site of a pulmonary air leak, the pleural cavity is filled with saline solution. The anesthesiologist ventilates the atelectatic lung,…
Bronchial Sleeve Resection
Figure 18.1a, b Surgical technique of bronchial sleeve resection and anastomosis construction. Intraoperative management for bronchial sleeve resections follows the standards for anatomical lung resections. Airway management with a right-…
Pleurectomy and Decortication for Mesothelioma
Figure 40.1 Positioning and approach. After the induction of general anesthesia, a double-lumen endotracheal tube is used to facilitate single-lung ventilation. Because blood loss is often significant with this procedure,…
Thymectomy (VATS, da Vinci)
Figure. 32.1 Minimally invasive thoracoscopic surgery using the three-armed da Vinci telemetric robotic system (Intuitive Surgical, Sunnyvale, CA). The procedure is performed under general anesthesia with single-lung ventilation. The patient…
Anatomic Segmental Resection
Figure 16.1 Concept of ‘classic (conventional)’ segmental resection (segmentectomy). According to the classic (conventional) concept of segmental resection, the segmental artery and bronchus, which run parallel, are both divided at…
Subglottic Tracheal Stenosis
Figure 5.1 Deep inhalation or total intravenous anesthesia is selected to avoid muscle relaxation before the airway is secured. No advantage is gained from dilating a stricture slated to be…
Thoracoplasty
1. First cleaning steps by tube, irrigation, etc. Dealing with bronchial stump in case of bronchopleural fistula 2. Débridement 3. Open window 4. Vacuum-assisted closure (VAC) 5. Space filling (a)…
Pulmonary Lobectomy (Thoracotomy and VATS)
Figure 17.1 Standard posterolateral thoracotomy incision. LD latissimus dorsi muscle Right Upper Lobectomy The lung is retracted laterally to place the superior hilar vessels on tension. The mediastinal pleura over…
Pneumothorax
Etiology Clinical appearance Size (British Medical Society) Spontaneous Closed pneumothorax (also called pneumothorax simplex) Small (lung <2 cm from the chest wall) Symptomatic Open pneumothorax Large (lung >2 cm from…
Nuss Procedure for Pectus Excavatum
Figure 45.1 Positioning. The patient is placed in the supine position with both arms abducted at a 10° angle to minimize tension in the cervicothoracic crossing and brachial plexus. The…
