Situation

A patient needs a thoracotomy, unfortunately they have had a previous thoracotomy on the same side. How do you open ?

Opinion

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Opinion

It is usual to open the same incision, but to go via a different rib space as the lung will be stuck to the previous rib space that was opened.

Opening via a parallel incision runs the risk of devascularising the tissues between the old and new incisions as the blood supply comes from above and below.