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Tracheal Resection and Reconstruction: How I Teach It

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Presentation on theme: "Tracheal Resection and Reconstruction: How I Teach It"— Presentation transcript:

1 Tracheal Resection and Reconstruction: How I Teach It
Douglas J. Mathisen, MD  The Annals of Thoracic Surgery  Volume 103, Issue 4, Pages (April 2017) DOI: /j.athoracsur Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Computed axial tomogram coronal view demonstrating upper third stenosis. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 (A) Collar incision is basic. For low lesions the upper sternal incision is added. Laryngeal release is performed through a short incision overlying the hyoid bone. (B) The manubrium is divided. A small pediatric sternal spreader separates the manubrium and gentle retraction on the innominate artery gives exposure. (Republished with permission from Edith Tagrin.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 (A, B). Placement of traction sutures proximally and distally in mid lateral position. (Republished with permission from Edith Tagrin.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 (A) Muscles inserting on the cephalad aspect of the hyoid bone are divided. (B) The hyoid bone is divided just lateral to the inferior cornu to allow “release.” (Republished with permission from Edith Tagrin.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 (A) Initial anastomotic suture (4-0 Vicryl [(Ethicon, Sornerville, NJ)]) posterior midline (6 o’clock). (B) Next suture placed lateral to the first and anterior to the first. (C) Each succeeding suture is placed in this pattern, clipped to the drapes caudad to the prior suture, but lying anterior to it. (Republished with permission from Edith Tagrin.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

7 Fig 6 The neck is flexed and maintained by two or three folded blankets. (Republished with permission from Edith Tagrin.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

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