Thoracic Incisions – Surgical Access to the Thoracic Cavity for Operations on the Lung

In standard and conventional surgery of the lung, there are a variety of incisions allowing access to the chest cavity. The common feature to all is to place the incision in a way which allows better surgical treatment for the lesion. The commonest approach is postero-lateral thoracotomy through the fifth inter space, with the patient placed on the operating table in an appropriate lateral position. This allows exploration of the lungs as well as the mediastinum. A prone position/face down also allows good exploration of the lungs and the postero mediastinum. All the anterior and anterolateral incisions allow limited exploration of the lungs and arterial mediastinum. In this chapter, the variety of incisions for the approach to the lung at different angles have been briefly described and illustrated. Important advantages of standard thoracotomy incisions and approaches to the thoracic cavity for lung cancer operations are: Firstly, ample visual inspection with/without optical technology assistance. Secondly, to enable the surgeon to use the palpation method, which is an important attribute not endowed by the minimal access VATS methods.

Keywords: Antero-Lateral, Anterior Thoracotomies, Median Sternotomy, Postero-Lateral, Standard Pulmonary Resection For Cancer.