Pulmonary Lobectomy
Objective
In cases of benign or malignant lesion limited to a lobe:
• Excision of one or more lobes of the lung bearing the tumor.
Position
Lateral.
Anesthesia
General.
Procedure
1. Lung is exposed through a posterolateral incision.
2. Diseased lobe is identified.
3. The visceral pleura is dissected free from the hilus.
4. The pulmonary artery and vein of the diseased lobe are ligated and divided.
5. The bronchus is isolated, doubly clamped and transsected.
6. Bronchial stump is sutured; more frequently a stapling device may be employed.
7. The suture line is tested for air leaks.
8. Hemostatis is achieved.
9. Chest tubes are inserted.
10. Chest is closed in layers.
11. Chest tubes are connected to a sealed drainage unit.
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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