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  • Title
  • 1. Introduction
  • 2. Incision and Fascial Dissection
  • 3. Muscle Harvesting
  • 4. Infrapyloric Mobilization
  • 5. Dissection of Pulmonary Structures
  • 6. Removal of Lung Lobe
  • 7. Closure
  • 8. Post-op Remarks

Open Left Upper Lobectomy in an Adult Cystic Fibrosis Patient

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Douglas O'Connell, MSc1; Christopher R. Morse, MD2
1Touro University College of Osteopathic Medicine
2Massachusetts General Hospital

Thoracic Surgery

Procedure Outline

Table of Contents

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

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                  Authors

                  Filmed At:

                  Massachusetts General Hospital

                  Article Information

                  Publication Date
                  Article ID192
                  Production ID0192
                  Volume2024
                  Issue192
                  DOI
                  https://doi.org/10.24296/jomi/192