DECORTICATION

 Lung decortication is a simple but technically demanding procedure. It involves the excision of the thick fibrinous peel from the pleural surface and visceral surface of the lung, so that the lung can expand.

1. Empyema thoracis

2. Long standing hemothorax

3.Pleural tumors.

4. Pleural thickening due to other causes.

Any disease causing lung collapse and encasement of lung in thick layers causes volume loss of ventilation surface of the lung. This causes problems like breathlessness or fever due to the infection and pus in the thoracic cavity.

Left lung collapsed with fluid filled in left pleural space.

Decortication through minithoracotomy.

Thick fibrous layer covering the lung being peeled off in decortication procedure. Notice fibrous layer grasped in forceps.

Video assistance in decortication procedure, VATS, to reach the more far areas of the lungs which can not be reached through small direct incision.

Small incision in chest wall closed in layers after completion of the decortication with VATS procedure.

Expanded left lung after decortication.