Tuesday, February 21, 2017

THORACIC SURGERY Thoracoplasty

Thoracoplasty (Removal of Rib)
Objective
In cases of extensive TB of the lungs:
   To cause a collapse of the lungs by removal of rib.
Position
Left or Right lateral position.
Anesthesia
General intubation.
Procedure
   1.  Cleaning of the patient with Savlon and painting with Tincture Iodine and draping.
   2.  Incision with No. 20 blade and No. 3 BP handle.
   3.  Cauterization with cutting cautery.
   4.  Elevation of the periosteum of the rib with periosteum elevator.
   5.  Cutting of the rib with rib cutter.
   6.  Sponge and instruments count.
   7.  Drainage: Under water seal drainage.
   8.  Muscle closure with No. 1-0 Vicryl.
   9.  Skin closure with 2-0 Vicryl.
10.  Dressing with Betadine ointment and gauze.
11.  Shifting of the patient.
Linen
Chest sheet 1 pkt, Gown 1 pkt, Chest drape 1 pkt, OPT 1 pkt.
Set
General set, water seal set, Rib resection set, Cleaning set.
Major procedure tray
   Retractor Davidson scapula                        1
   Duvals lung holding forceps                     2
   Sinus rib holding forceps                          1
   Dorham’s aneurysm needle                       2
   Retractor Allisoi’s (Lung retractor )           1
   Periosteum elevator notch type                 2
   Bronchus clamp                                          2
   Dissector W/S                                             1
•           Stinskey clamp

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