Page 164 - BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery, 2nd Edition

Chapter 11 ·
Chapter 11 · Thoracic wall anatomy and surgical approaches
Thoracic wall anatomy and surgical approaches

➜ OPERATIVE TECHNIQUE 11.1 CONTINUED
VetBooks.ir 5 The pleura is a distinct structure and is penetrated by blunt puncture and then opened to the extent of the

thoracotomy using scissors. The edges of the intercostal thoracotomy incision should be protected with
moistened laparotomy sponges, and Finochietto rib retractors are recommended to maintain retraction of the ribs
and maximize exposure of the thoracic cavity.

pleura rib. L = lungs.

This dog has lung lobe torsion (LLT).
F Finochietto rib retractors
LS = laparotomy sponge.

6 Following completion of the surgical procedure, a
thoracostomy tube can be inserted into the
ipsilateral hemithorax, depending on the disease
and whether further fluid or air accumulation is
anticipated in the postoperative period. For
diseases in which this is unlikely, a temporary
thoracostomy tube, such as an 8 Fr urinary
catheter or infant feeding tube, can be placed
through the intercostal thoracotomy incision.
Regardless, the thoracostomy tube should be
kept open to the atmosphere during closure of
the thoracotomy to prevent tension
pneumothorax. Once an airtight closure is
achieved, air and fluid are evacuated from the
pleural space, negative intrathoracic pressure is
re-established, and the thoracostomy tube is
then closed.

L latissimus dorsi muscle serratus ventralis muscle
TT = thoracostomy tube (arrowed).

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