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1. Introduction
2. Incision and Fascial Dissection
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a. Position Patient
b. Mark Incision
c. Make Initial Incision
3. Muscle Harvesting
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a. Score Rib for Periosteum Harvest
b. Remove Periosteum from Sixth Rib
c. Remove Periosteum from Fifth Rib
d. Harvest Intercostal Muscle
4. Infrapyloric Mobilization
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a. Shingle Sixth Rib
b. Spread Ribs
c. Complete Harvest of Intercostal Muscle Flap
5. Dissection of Pulmonary Structures
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a. Remove Adhesions
b. Dissect Hilum and Pleura
c. Take Down Inferior Pulmonary Ligament
d. Dissect Superior and Inferior Pulmonary Veins
e. Mobilize Plurae off Pulmonary Artery
f. Create Approach around Superior Pulmonary Vein
6. Removal of Lung Lobe
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a. Tie off and Section Pulmonary Vein
b. Tie off and Resect Apical Pulmonary Artery Branches
c. Divide Airway off of Pulmonary Artery
d. Clamp and Divide Bronchus
e. Remove Left Upper Lobe
f. Reinforce Staple Line
7. Closure
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a. Place Chest Tubes
b. Close Ribs
c. Close Muscle Layers
d. Close Skin
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Open Lobectomy
Christopher Morse, MD
Massachusetts General Hospital
Tags:
General Surgery
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Authors
Christopher Morse, MD
Filmed At:
Massachusetts General Hospital
Article Information
Publication Date
N/A
Article ID
192
Production ID
0192
Volume
N/A
Issue
192
DOI
https://doi.org/10.24296/jomi/192