Thoracotomy
Thoracotomy is a
surgery that requires an incision into the chest wall. It is more invasive than Thoracoscopy. It allows the doctor to look directly at the lungs or other part of the chest cavity, including the surrounding protective bones. It also gives an opportunity for the doctor to takes tissue samples for
biopsy, or to remove sections of diseased tissue. Thorocotomy is also used for examining the heart and aorta. Although ordinarily a planned procedure, thorocotomy is also used in emergency situations to control and assess internal bleeding. A doctor may also have to do direct heart massage to keep the heart beating or to get it beating again in a near death situation (1).
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Incisions for thorocotomy can be made on the side of the body, called an axillary thorocotomy. When the incision is made on the front of the body, under the breastbone it is called anterolateral thorocotomy. If the breastbone itself has to be cut, it is sewn back together with wire. With an incision between the ribs,( intercostal thorocotomy), fewer bones and muscles are impacted. One lung has to be deflated to allow sufficient room in the chest cavity for the doctor to do the examination, while the other lung is assisted with ventilators.
A small percentage of patients having thorocotomy get infections in the wound, have continuing problems with their lungs including pneumothorax and pneumonia, or surgery related heart problems. This procedure can be associated with extreme pain, unless treated appropriately with painkillers. Of course these medications carry risks of their own unless carefully monitored by the doctors and taken according to directions by the patient.