Anterolateral thoracotomy

Start the incision 4 fingers inferior to the nipple in the midclavicular line and continue along the submammary crease.

Note: When making the incision in women, it is important to prevent possible cosmetic problems along the breast.

Continue the incision diagonally to the posterior axillary line at a point about 2 fingers superior to the tip of the scapula.

Note: Depending on the case at hand, the incision may be extended as far as the sternum. In posterolateral thoracotomy, continue the incision around the tip of the scapula to about 4 fingers lateral to the spinous processes.

Divide the subcutaneous fatty tissue with electrocautery down to the muscles.

Next, divide the serratus anterior down to the ribs while sparing the latissimus dorsi, by retracting it posteriad.

Note: Minimize blood loss by dividing the muscles of the chest wall with electrocautery.