Our Summary

This research paper talks about a different method used for lung transplants. Traditionally, lung transplants are done using a method called clamshell thoracotomy or bilateral anterior thoracotomy incisions. However, from 2013 to 2017, the authors have carried out 121 lung transplants using a different method known as a median sternotomy incision. In this paper, they explain this technique and discuss its possible benefits.

FAQs

  1. What is the traditional method of performing lung transplantation?
  2. What is a median sternotomy incision and how is it utilized in lung transplantation?
  3. How many lung transplants have been performed using a median sternotomy incision between 2013-2017?

Doctor’s Tip

A doctor may advise a patient who has undergone a sternotomy for lung transplantation to avoid heavy lifting or strenuous activity for a certain period of time to allow for proper healing of the incision. It is also important to follow all post-operative instructions provided by the medical team to ensure a successful recovery. Regular follow-up appointments and monitoring of the incision site are essential in the post-operative period.

Suitable For

Patients who are recommended sternotomy for lung transplantation may include those with:

  • Severe bilateral lung disease
  • Patients requiring a bilateral lung transplant
  • Patients with complex or extensive lung pathology
  • Patients who may benefit from a shorter operative and recovery time
  • Patients with a history of previous thoracic surgeries that may complicate other approaches

It is important to consult with a multidisciplinary team of specialists to determine the best approach for each individual patient.

Timeline

Before sternotomy:

  1. Patient undergoes thorough evaluation and screening process to determine eligibility for lung transplantation.
  2. Patient receives preoperative counseling and education about the procedure and potential risks and benefits.
  3. Patient undergoes preoperative testing, such as blood work, imaging studies, and pulmonary function tests.
  4. Patient is admitted to the hospital on the day of surgery and prepared for the procedure.

After sternotomy:

  1. Patient is brought to the operating room and undergoes induction of anesthesia.
  2. Surgeon makes an incision in the middle of the chest, through the sternum, to access the lungs.
  3. Cardiopulmonary bypass is initiated to support the patient’s circulation during the procedure.
  4. Surgeon removes the diseased lungs and replaces them with donor lungs.
  5. The new lungs are connected to the patient’s airways and blood vessels.
  6. The sternum is closed with sutures or wires, and the incision is closed with staples or sutures.
  7. Patient is transferred to the intensive care unit for monitoring and recovery.
  8. Patient undergoes postoperative care, including pain management, breathing exercises, and physical therapy.
  9. Patient is discharged from the hospital once stable and able to care for themselves at home.
  10. Patient undergoes regular follow-up appointments to monitor their progress and adjust medications as needed.

What to Ask Your Doctor

  1. Why are you recommending a sternotomy for my lung transplant surgery instead of a traditional thoracotomy incision?
  2. What are the potential risks and complications associated with a sternotomy incision for lung transplantation?
  3. How will a sternotomy affect my recovery time and post-operative pain compared to a traditional incision?
  4. Will a sternotomy incision impact my long-term lung function or overall health after the transplant?
  5. What specific steps will be taken during the surgery to minimize the risks and potential complications associated with a sternotomy incision?
  6. How experienced are you and your surgical team in performing lung transplants with a sternotomy incision?
  7. Are there any alternative surgical approaches or incision techniques that could be considered for my lung transplant surgery?
  8. What should I expect in terms of scarring and physical appearance after a sternotomy incision for lung transplantation?
  9. How will a sternotomy incision impact my ability to participate in physical activities or daily tasks during my recovery period?
  10. Are there any additional resources or information available to help me better understand the use of a sternotomy incision for lung transplant surgery?

Reference

Authors: Teman NR, Xiao JT, Tribble CG, Parrino PE. Journal: Heart Surg Forum. 2017 Jun 19;20(3):E089-E091. doi: 10.1532/hsf.1809. PMID: 28671862