Thoracotomy is a surgical procedure that involves making an incision into the chest wall to access the thoracic organs like the heart, lungs, esophagus, or thoracic aorta. There are three main types of incisions: posterolateral, anterolateral, and axillary. The posterolateral incision is the gold standard as it provides optimal access to the lungs and pulmonary hilum. It involves cutting between the scapula and mid-spinal line. The anterolateral incision runs from the sternum to the mid-axillary line and divides the pectoralis major and serratus anterior muscles. The axillary incision is muscle-sparing and made under

1. Thoracotomy
By kajal sansoya

2. What is Thoracotomy ?
o It is process of making an incision into the
chest wall.
o Performed by a surgeon , to gain access to the
thoracic organs, most commonly heart, lungs
and esophagus or thoracic aorta & sometimes
to access the tumors in spine.

3. Purpose
o Thoracotomy allows to study the conditions
of the lungs such as removal of lung or part of
lung or removal of rib.
o Thoracotomy also provide access to heart ,
diaphragm and portions of aorta which passes
through the chest cavity.
o Lung cancer is most common cancer requiring
a thoracotomy. Tumors growth can be
removed through the incision.

4. Approaches to Thoractomy
• There are 3 main subtypes of thoracotomy
incisions
Posterolateral incision
Anterolateral incision
Axillary incision

5. Posterolateral
• It is a gold standard for access to the thorax. It
provides access to all thoracic viscera, & is
mainly used for pulmonary resections.
• It is very common approach for operations on
lungs. When performed on 5th intercostal
space , it allows optimal access to pulmonary
hilum( pulmonary artery and pulmonary vein)
• Incision of choice for pulmonary resections i.e
pneumonectomy & lobectomy.

6. • Incision is made in patient in lateral decubitus
position.
• It starts from between scapula and mid-spinal
line and extends laterally to anterior axillary
line.
• Before reaching thoracic cavity, incision is
passed through latissimus dorsi & serratus
anterior muscle then transects the rhomboids
& tapezius.

7. Lateral decubitis position is an ideal position to perfome
thoracotomy

9. Anterolateral
• Incision is made under breast. Incision can be
used in a variety of operations for cardiac,
pulmonary and oesophageal pathology.
• Left anterolateral thoracotomy is incision of
choice for open massage.
• Incision runs from lateral border of sternum to
the mid-axillary line at 4th or 5th intercostal
space, dividing through the pectoralis major &
serratus anterior in it approach.

10. Bilateral thoracotomy combine with transverse
thoracotomy results in clamshell incision , the largest
incision commonly used in thoracic surgery.

11. Axillary
• Axillary thoracotomy is a muscle sparing
approach to the thoracic cavity used for
pneumoectomy and pneumothorax
operations.
• Incision is made on the side, under the arm ,
between posterior border of the pectoralis
major & anterior border of latissimus dorsi
muscles, through the 4th and 5th intercostal
space.

12. • Incision reduces muscle damage and has good
cosmetic outcomes.
• Gave exposure to thoracic viscera.
• It is choice of incision in majority of PDA
conditon and pulmonary resections
conditions.

15. Thank you
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