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Anatomical landmarks serve as orientation. The dashed line describes the course of the latissimus dorsi muscle. The 5th rib is usually located on an imaginary line between the scapula tip and the nipple. In the 4th intercostal space above, a 5 cm minithoracotomy is performed with the insertion of a wound protection retractor. Subsequently, under camera view, the incisions for the additional trocars can be made in the area of the 7th or 8th intercostal space ventrally and dorsally.
Note:
- With atraumatic technique and in skilled hands, it may also be advantageous to first make the caudal incision. After camera exploration through the caudal access, the placement of the minithoracotomy as a working access can be optimally adapted to the anatomical conditions.