2019 AMI Online Salon

Right Apical Wedge Resection – Steps 3 and 4

Project Details

  • Company/Institution: Johns Hopkins University
  • Entrant Name: Cecilia Johnson
  • Membership Type: Student Submission   
  • Address: Baltimore, MD
  • Client: Corinne Sandone
  • Medium/software used: Adobe Photoshop CC
  • Final presentation format: Slide presentation
  • Primary Audience: Surgeons and surgical residents

Project Description

In this case study, a patient was undergoing surgical treatment for recurrent spontaneous pneumothorax (lung collapse), for which the cause is typically unknown. Early in the operation, the surgeon discovered a bronchopleural fistula, a rare pathological connection from a bronchus to the visceral pleura causing a direct flow of air from the lungs into the pleural space. The fistula was identified as the cause of the recurrent pneumothorax and ultimately removed via an apical wedge resection.

This illustration depicts the dramatic moment the surgeon identifies the fistula while removing strong adhesions from the lung to the chest wall using (3) blunt dissection and (4) electrocautery to free the lung. Thoracoscopic access of the right lateral lung is depicted; the bronchus is labeled for orientation. The bronchi were drawn from reconstructed patient CT data. Didactic coloring of the path from the bronchus to the fistula draws viewers’ attention to the cause and location of the fistula.