FIELD: medicine.
SUBSTANCE: necessary tests are taken before the procedure, and the point in projection of the most significant parietal pleura abnormalities is marked on patient's skin. In this point, 2.5-3.0 cm incision is made through skin and subcutaneous fat along the intercostals space, with following dissection of subjacent muscles in the same direction with fibers till intercostals space and followed by moving them aside. The intercostal muscles are dissected for 2.5-3.0 cm till the underpleural fascia along the upper margin of the subjacent rib, and the intercostal space is widen by two Farabeuf retractors, which are inserted into the wound's angle and swung about at 90° to make a spacer. Then, the pleural sheet-anchor is dissected along the upper and lower ribs till the visceral pleura through created wound aperture, to connect the horizontal incisions with vertical ones. After that, the angel of dissected fragment is clipped by forceps, pulled of the lung and the pleural sheet-anchor is dissected from the visceral pleura for 4-5 mm. In the projection of the marked point, biopsy is performed under visual control, by dissecting the one tissue bloc including the parietal and visceral pleura, and with following layered closure.
EFFECT: method enables pleural biopsy in localised encapsulated processes with minimal surgery, without thoracoscopy and with use of one tissue bloc dissection.
1 ex, 5 dwg
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Authors
Dates
2008-05-20—Published
2007-04-17—Filed