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Tenth Rib: Thoracoabdominal Approach

  • Robert G. Watkins

Abstract

1. Place the patient in the lateral decubitus position. Approach from the convexity of the scoliosis or from the left side when possible. A left-sided approach is preferred because of ease of mobilization of the aorta compared with the vena cava. In addition, splenic retraction is easier than hepatic. Incise the skin and subcutaneous tissue from the lateral border of the paraspinous musculature over the 10th rib to the junction of the 10th rib and costal cartilage.1 Curve the incision anteriorly from the tip of the 10th rib to the lateral rectus sheath and distally down the edge of the sheath as far as necessary for exposure (Fig. 18A). Exteud the wound slowly through each muscle layer with the electrocautery. The assistant aggressively picks up bleeders with two Adson forceps.

Keywords

Lateral Decubitus Position Paraspinous Musculature Retroperitoneal Space Costal Cartilage Abdominal Musculature 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

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    Riceborough EJ: The anterior approach to the spine for correction of the axial skeleton. Clin Orthop 93:207–214,1973.CrossRefGoogle Scholar
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    Dwyer AF, Newton NC, Sherwood AA: An anterior approach to scoliosis. Clin Orthop 62:192, 1969.Google Scholar
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    Dwyer AF: Experience of anterior correction of scoliosis. Clin Orthop 93:192–201, 1973.Google Scholar
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    Scott R: Innervation of the diaphragm and its practical aspects in surgery. Thorax 20:357, 1965.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2003

Authors and Affiliations

  • Robert G. Watkins
    • 1
    • 2
  1. 1.Clinical Orthopedic SurgeryUniversity of Southern CaliforniaLos AngelesUSA
  2. 2.St. Vincent’s HospitalLos Angeles Spine Surgery InstituteLos AngelesUSA

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