Description of Event or Problem · 1
DURING POSTEROLATERAL THORACOTOMY, THE RIBS WERE SPREAD, PLEURAL SPACE INSPECTED, WE THEN TOOK DOWN THE INFERIOR PULMONARY LIGAMENT AND OPENED THE PARIETAL PLEURA ON EITHER SIDE OF HILUM. INFERIOR PULMONARY VEIN WAS TAKEN WITH A STAPLER. WE THEN ENTERED THE FISSURE AND IDENTIFIED THE PULMONARY ARTERY BRANCHES GOING TO THE SUPERIOR SEGMENT OF LOWER LOBE & INFERIOR SEGMENTS OF LOWER LOBE. BRANCH GOING TO SUPERIOR SEGMENT WAS TAKEN W/A STAPLER. WE THEN PLACED A STAPLER ON THE BRANCHES GOING TO LOWER LOBE MAKING SURE WE DID NOT TAKE BRANCH GOING TO LINGULA. WE APPLIED THE STAPLER, BUT THE STAPLER MISFIRED AND LEFT A HOLE IN THE PULMONARY ARTERY HERE. WE PLACED CLAMPS PROXIMALLY AND DISTALLY, BUT DID LOSE SOME BLOOD AT THIS POINT. WE TRANSECTED THE PULMONARY ARTERY AND OVER SEWED BOTH CUT ENDS W/PROLENE SUTURE. CLAMPS REMOVED AND WE HAD ADEQUATE HEMOSTASIS. WE THEN DISSECTED OUT THE 2 MAIN BRONCHIAL BRANCHES GOING TO LOWER LOBE. THESE WERE THEN CLAMPED W/STAPLER. WE INFLATED THE LEFT LUNG AND MADE SURE THE LEFT UPPER LOBE INFLATED FULLY AND THAT NO AIR WAS GOING TO THE LOWER LOBE. ONCE THIS WAS INSURED, WE DEFLATED THE LEFT UPPER LOBE AND FIRED THE STAPLER. THE BRONCHUS WAS EXCISED W/STAPLER. THE FISSURE WAS TAKEN W/STA0PLERS AND THE LUNG WAS REMOVED AND PASSED OFF THE FIELD AS SPECIMEN, CLOSED, PATIENT EXTUBATED, AND TRANSFERRED TO ICU IN GUARDED CONDITION.