Page 163 - BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery, 2nd Edition

Neck and
Thoracic Surger
eline Head,
A Manual of Canine and F
V
BSA
BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery
y
➜ OPERATIVE TECHNIQUE 11.1 CONTINUED
VetBooks.ir SURGICAL TECHNIQUE

1 An incision is made through the skin, subcutaneous
tissue and cutaneous trunci muscle from the
costovertebral junction dorsally to the sternum
ventrally and running parallel to the ribs over the
desired intercostal space.

LD = latissimus dorsi muscle.

2 The latissimus dorsi and pectoral muscles are
incised parallel to the skin incision across their
muscle fibres. The desired intercostal space for the
thoracotomy is identified by either counting ribs and
intercostal spaces, usually from the first rib caudally,
and/or identifying the fifth rib. The external
abdominal oblique muscle originates from the fifth
rib and the scalenus muscle inserts on the fifth rib.

L latissimus dorsi muscle serratus ventralis muscle.

3 One of these muscles is incised, depending on
whether the intercostal thoracotomy is cranial
(scalenus muscle) or caudal (external abdominal
oblique muscle) to the fifth rib. The serratus ventralis
muscle is separated between its muscle bellies or
incised parallel to its fibres to expose the intercostal
space.

CT cutaneous trunci muscle L latissimus dorsi muscle
C scalenus muscle serratus ventralis muscle.
4 The external and internal intercostal muscles are
then incised in the middle of the intercostal space to
avoid iatrogenic trauma to the intercostal vessels
coursing over the caudal aspect of the ribs.

IC intercostal muscles pleura
rib serratus ventralis muscle.

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