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Open Left Upper Lobectomy in an Adult Cystic Fibrosis Patient
Table of Contents
1. Introduction
2. Incision and Fascial Dissection
- Position Patient
- Mark Incision
- Make Initial Incision
3. Muscle Harvesting
- Score Rib for Periosteum Harvest
- Remove Periosteum from Sixth Rib
- Remove Periosteum from Fifth Rib
- Harvest Intercostal Muscle
4. Infrapyloric Mobilization
- Shingle Sixth Rib
- Spread Ribs
- Complete Harvest of Intercostal Muscle Flap
5. Dissection of Pulmonary Structures
- Remove Adhesions
- Dissect Hilum and Pleura
- Take Down Inferior Pulmonary Ligament
- Dissect Superior and Inferior Pulmonary Veins
- Mobilize Plurae off Pulmonary Artery
- Create Approach Around Superior Pulmonary Vein
6. Removal of Lung Lobe
- Transect Pulmonary Vein
- Transect Apical Pulmonary Artery Branches
- Divide Airway off of Pulmonary Artery
- Transect Bronchus
- Resect Left Upper Lobe
- Reinforce Staple Line
7. Closure
- Place Chest Tubes
- Close Ribs
- Close Muscle Layers
- Close Skin