Wiki Thoracotomy

[TWilliam2019]

Next, a standard thoracotomy incision was completed and a partial resection of the 6th rib was done. The retractor was then placed for exposure. Next, There was significant pleural rind with lobe fusion to the chest wall in some areas. The lower lobe was carefully freed with blunt dissection. A large pleural effusion was present. Some of this fluid was collected in a Luekens trap and passed off the field for culture. A complete decortication began with the lower lobe. The diaphragmatic surface was freed. Some pleural rind was removed and passed off the field as specimen. The major fissure was complete. The middle and upper lobes were fused and were separated carefully. The mediastinal surfaces of the the lung was freed with careful blunt dissection to the level of the apex. Additional pleural rind was removed form all surfaces of the lung to allow for re-expansion. Next, the lower lobe had an area with an abscess that was necrotic and therefore I decided to perform a wedge resection back to healthy appearing lung with serial GIA purple and black load staplers and the specimen was passed off to pathology. Next, two 32Fr chest tubes were placed, one posteriorly along the diaphragm and one toward the apex. Hemostasis was verified, the ribs were re approximated with number 2 vicryl sutures and the lung was then re-expanded under direct vision. All skin incisions were closed in layers with 0 and 2-0 Vicryl and the skin was closed with staples.

At this stage, the procedure was discontinued. The patient was delivered from anesthesia, extubated, and transferred to the postanesthesia recovery unit in stable condition having tolerated the procedure well. I was present and active throughout the entire procedure.

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a partial resection of the 6th rib was done ? is this codable