Thoracic Surgery pneumonectomy

Pneumonectomy

Objective

•   Removal of the lung in cancer 

•   In bronchiectasis.

Position

Lateral.

Anesthesia

General.

Procedure

1.  Affected lung is exposed through a posterolateral thoraco­tomy.

2.  Chest is explored.

3.  Metastases contraindicate resection, in which case chest tubes are inserted, the wound is closed, and chest tubes are connected to a sealed drainage unit.

4.  The mediastinal pleura is dissected free.

5.  The bronchus, pulmonary artery and veins are ligated.

6.  The bronchial stump is clamped, transsected and sutured or stapled.

7.  Lymph node-bearing tissues are excised as necessary.

8.  Hemostasis is achieved.

9.  Chest is closed in interrupted layers.

Instruments

•   Major procedures tray 

•   Thoracotomy tray 

•   Vascular procedures tray 

•   Hemoclip appliers, assorted sizes, long handled 

•   Long Pean clamps 

•   Stapling devices 

•   Cushing vein retractors 

•   Basin set 

•   Suction tubing 

•   Blades (3) No. 10, (1) No. 15 

•   Dissectors

•   Asepto syringes (2) 

•   Staples

•   Hemoclips

•   Vessel loops, umbilical tapes 

•   Chest drainage tube(s) 

•   Connector for example, straight or large Y 

•   Sealed drainage unit.

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