Thoracoscopic Chest Wall Resection: What Is Its Role?

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Thoracoscopic Chest Wall Resection: What Is Its Role? Todd L. Demmy, MD, Chukwumere E. Nwogu, MD, Sai Yendamuri, MD The Annals of Thoracic Surgery Volume 89, Issue 6, Pages S2142-S2145 (June 2010) DOI: 10.1016/j.athoracsur.2010.02.110 Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Composite port schematics and video still images illustrated a limited en bloc chest wall resection. (A) Division of the anteromedial rib through the access incision with a standard rib shear is shown. The inset shows camera location and the arrow indicates where the shear divided the rib through the access incision. (B) Longitudinal division of the intercostal muscles with sealant energy (Ligasure) is shown in the top right panel. In the lower right panel, division of the posterior neurovascular pedicle is shown after dissection with a right-angle clamp. The inset shows the ports used for camera and energy device insertion and the clamp that hooked and delivered the neurovascular pedicle for division via the access incision. The star indicates the area of chest wall invasion. (C) The posterolateral rib is divided with an endoscopic rib cutter. The inset shows the ports used for camera and the endoscopic rib cutter. The Annals of Thoracic Surgery 2010 89, S2142-S2145DOI: (10.1016/j.athoracsur.2010.02.110) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions