Muscle-sparing Axillary Thoracotomy

The standard posterolateral thoracotomy provides excellent exposure to the chest and has traditionally been the incision of choice for major intrathoracic operations. However, this approach comes at the cost of muscle-splitting, with significant postoperative pain and impairment in function, particularly in elderly patients. Consequently, muscle-sparing approaches have been met with enthusiasm due to improvements in postoperative pain, morbidity, and cosmesis. Although concerns regarding exposure initially limited the use of this incision, advances in technology and experience have led to more widespread use of the muscle-sparing approach. Today, the muscle-sparing thoracotomy is the incision of choice for many surgeons, as it can be used as an adjunct to video-assisted thoracoscopic surgery and has successfully been employed in complex thoracic procedures.