Decortication of the Lung Thoracoscopic Decortication

Decortication of the Lung Thoracoscopic Decortication

Skip to main content

The Cardiothoracic Surgery Network
  • About
    • Participation
    • Strategic Plan
    • Sponsors
    • Sponsorship
    • Disclaimer
    • Privacy Policy
    • Comment Policy
    • Contact Us
  • Submit
    • Submission Guidelines
    • Submission Form
    • Altmetric
  • Events
    • Events Listing
    • Events Calendar
    • Submit an Event
    • Abstract Deadlines
  • JANS
  • Apps
  • Log in
    • Register an account

CTSNet is sponsored in part by an educational grant from

width=”156″ height=”25″ alt=”” />

  • Home
  • Videos
    • Cardiac
    • Congenital
    • Thoracic
    • Vascular
    • Roundtable Videos
    • Giants of Cardiothoracic Surgery
    • Pioneers in Cardiac Surgery
    • Innovators
  • Techniques
    • Cardiac
    • Congenital
    • Thoracic
  • Portals
    • Cardiac
    • Congenital
    • Thoracic
    • Vascular
    • Allied Health
    • Aortic
    • Meeting Presentations
    • Surgical Volunteerism
    • Ethics
  • Journals
    • Journals
    • CTSNet Journal and News Scan
    • Books
  • Careers
    • U.S. Career Center
    • European Career Center
    • 2019 Career Fair
  • Profiles
    • Surgeons
    • Associates
    • Organizations
    • Industry
  • Residents
  • Submit Content
  • Events
    • Events Listing
    • Events Calendar
    • Abstract Deadlines
    • Submit an Event
  • About
    • Participation
    • 2014 CTSNet Strategic Plan
    • CTSNet Strategic Plan
    • Sponsors
    • Sponsorship
    • Submit Content to CTSNet
    • Disclaimer
    • CTSNet Privacy Policy
    • CTSNet Comment Policy
    • Contact Us
  • Apps
  • Log in
    • Register an account




This site is not optimized for Internet Explorer 8 (or older).

Please upgrade to a newer version of Internet Explorer or use an alternate browser such as Chrome or Firefox.

Robotic-Assisted Total Decortication of Right Lung for Fibrothorax

Monday, June 25, 2018


G. Jett

Jett GK. Robotic-Assisted Total Decortication of Right Lung for Fibrothorax. June 2018. doi:10.25373/ctsnet.6609419 .

This video describes robotic-assisted decortication for a recurrent pleural effusion secondary to fibrothorax. Technical aspects of the decortication are demonstrated, including port placement, robot docking, and closure.

Decortication is occasionally needed for an infected pleural space or recurrent pleural effusion caused by a trapped lung resulting from fibrothorax or malignant process (1). Outcomes of video-assisted thoracoscopic decortication have been shown to reduce complications and mortality (2), and conversion to open thoracotomy is more frequent with longer duration of the empyema or fibrothorax (3). Lung decortication, which re-expands the affected lung, has been shown to improve the quality of life in patients with trapped lungs following coronary artery bypass grafting (4).


  1. Rathinam S, Waller, DA. Pleurectomy decortication in the treatment of the “trapped lung” in benign and malignant pleural effusions. Thorac Surg Clin. 2013;23(1):51-61 .
  2. Tong BC, Hanna J, Toloza EM, et al. Outcomes of video-assisted thoracoscopic decortication. Ann Thorac Surg. 2010;89(1):220-225 .
  3. Landreneau RJ, Keenan RJ, Hazelrigg SR, Mack MJ, Naunheim KS. Thoracoscopy for empyema and hemothorax. Chest. 1996;109(1):18-24 .
  4. Celik S, Celik M, Aydemir B, Tunckaya C, Okay T, Dogusoy I. Long-term results of lung decortication in patients with trapped lung secondary to coronary artery bypass grafting. Ann Thorac Cardiovasc Surg. 2012;18(2):109-114 .

Dr Jeff is a proctor and speaker for Intuitive Surgical, Inc.


Submitted by
David Cooke
Interesting. Appears to be a very early fibrino-purulent empyema which may make robotic decortication likely successful.

0 users have voted.
You need to be logged in to vote

Add comment

Log in or register to post comments

Submit Content

Rate article

  • up

  • down

You need to be logged in to vote


Twitter logo Facebook logo Google+ logo LinkedIn logo


  • Thoracic
  • Residents
  • Videos – General
  • Lung – Other
  • Robotic Thoracic Surgery


  • Three-Dimensional Printing-Guided Precise Surgery for Complex Pulmonary Arteriovenous Malformation
  • Pulmonary Alveolar Microlithiasis: A Rare Indication for Pulmonary Transplantation
  • CTSNet Step-by-Step Series: Posterolateral Thoracotomy
  • Subxiphoid Uniportal Lung Volume Reduction Surgery



From Wikipedia, the free encyclopedia

Jump to navigation
Jump to search

ICD-9-CM 34.51 – 34.52
[ edit on Wikidata ]

Decortication is a medical procedure involving the surgical removal of the surface layer, membrane , or fibrous cover of an organ . The procedure is usually performed when the lung is covered by a thick, inelastic pleural peel restricting lung expansion. In a non-medical aspect, decortication is the removal of the bark, husk, or outer layer, or peel of an object. [1] It may also be done in the treatment of chronic laryngitis . It is the primary treatment for fibrothorax .

Procedure[ edit ]

Decortication is performed under general anaesthesia . It is a major thoracic operation that has traditionally required a full thoracotomy . Since the early ’90s this procedure has increasingly been performed using more minimally invasive thoracoscopy . All fibrous tissue is removed from the visceral pleural peel and pus is subsequently drained from the pleural space. [2]

Contraindications[ edit ]

Other than the overall health of the patients, there are no absolute contraindications. In some lung-disease patients, the lung will not expand after removal of the pleural peel, rendering the surgery futile. Other diseases that render decortication futile are narrowing of the large airway stenosis and uncontrolled pleural infection. With these conditions, the lung will not expand to fill the thorax space. A major surgery called a pleuropneumonectomy can be the only available option, but only if the patient has been worked up before the surgery. Pleuropneumonectomy is a major surgery with a very high mortality and high invasiveness [3] .

References[ edit ]

  1. ^ The American Heritage Dictionary of the English Language, Fourth Edition . Copyright © 2000 by Houghton Mifflin Company. Published by the Houghton Mifflin Company
  2. ^ Sharma, Dr. Sat (2006-06-23). “Pulmonary Empyema” . WebMD . Retrieved 2007-02-18.

  3. ^ “Decortication: Background, Indications, Contraindications” . 2018-03-21.
  • v
  • t
  • e
Tests, surgery and other procedures involving the respiratory system ( ICD-9-CM V3 21–22, 30–34, ICD-10-PCS 0B )
Upper RT
Acoustic rhinometry

Laryngotracheal reconstruction
Lower RT
Tracheoesophageal puncture
Wedge resection
Lung transplantation
Decortication of lung
Heart–lung transplant
Chest wall , pleura ,
mediastinum ,
and diaphragm
pleura / pleural cavity
Chest tube
Nuss procedure
Medical imaging
  • Bronchography
  • CT pulmonary angiogram
  • High-resolution computed tomography
  • Spiral CT
  • Ventilation/perfusion scan
  • Pneumonia severity index
  • CURB-65
Lung function test
  • Body plethysmography
  • Spirometry
  • Bronchial challenge test
  • Capnography
  • Diffusion capacity
  • Sputum culture
  • Bronchoalveolar lavage
Respiratory therapy /
  • Artificial respiration
  • CPR
  • Hyperbaric medicine
  • Decompression chamber
  • Heliox
  • Mechanical ventilation
  • Nebulizer
  • Negative pressure ventilator
  • Oxygen therapy
  • Positive pressure ventilation
  • Postural drainage
  • Surgical airway management

Stub icon This surgery article is a stub . You can help Wikipedia by expanding it .

  • v
  • t
  • e

Retrieved from ” ”
Categories :

  • Surgical removal procedures
  • Pulmonary thoracic surgery
  • Thoracic surgical procedures
  • Surgery stubs
Hidden categories:

  • All stub articles

Navigation menu

Personal tools

  • Not logged in
  • Talk
  • Contributions
  • Create account
  • Log in


  • Article
  • Talk



    • Read
    • Edit
    • View history



      • Main page
      • Contents
      • Featured content
      • Current events
      • Random article
      • Donate to Wikipedia
      • Wikipedia store


      • Help
      • About Wikipedia
      • Community portal
      • Recent changes
      • Contact page


      • What links here
      • Related changes
      • Upload file
      • Special pages
      • Permanent link
      • Page information
      • Wikidata item
      • Cite this page


      • Create a book
      • Download as PDF
      • Printable version


      • العربية
      • Deutsch
      • Polski
      Edit links

      • NCBINCBI Logo
      • Skip to main
      • Skip to
      • Resources
      • How To
      • About NCBI Accesskeys
      My NCBI Sign in to NCBI Sign Out


      US National Library of Medicine

      National Institutes of Health
      • Advanced
      • Journal list
      • Help
      • Journal List
      • Can Med Assoc J
      • v.89(25); 1963 Dec 21
      • PMC1922283
      Logo of canmedaj

      Can Med Assoc J. 1963 Dec 21; 89(25): 1260–1265.
      PMCID: PMC1922283
      PMID: 14098889

      Decortication of the Lung

      R. B. Lynn and J. L. Wellington
      Copyright and License information Disclaimer
      Copyright notice


      Excision of an empyema sac and thickened pleura from the lung and chest wall has been performed for over 70 years. The most appropriate fields of application of this procedure are in treatment of tuberculous empyema, empyema complicating pneumonic processes (most frequently caused by staphylococcal infection), and clotted hemothorax following chest injury. The authors’ experience with 33 such decortications in the past five years is described, observations concerning the techniques, complications, and end results of the procedure are discussed, and illustrative case reports are presented.

      Full text

      Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (3.2M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References .
      icon of scanned page 1260


      icon of scanned page 1261


      icon of scanned page 1262


      icon of scanned page 1263


      icon of scanned page 1264


      icon of scanned page 1265



      Images in this article

      Fig. 1

      Fig. 1
      on p.1262

      Fig. 2

      Fig. 2
      on p.1262

      Fig. 3

      Fig. 3
      on p.1262

      Fig. 4

      Fig. 4
      on p.1263

      Fig. 5

      Fig. 5
      on p.1263

      Fig. 6

      Fig. 6
      on p.1263

      Fig. 7

      Fig. 7
      on p.1264

      Fig. 8

      Fig. 8
      on p.1264

      Fig. 9

      Fig. 9
      on p.1264

      Click on the image to see a larger version.

      Selected References

      These references are in PubMed. This may not be the complete list of references from this article.
      • GALE GL, DELARUE NC. Decortication in pleural and pulmonary tuberculosis. Can J Surg. 1962 Apr;5:172–179. [ PubMed ]

      Associated Data

      Supplementary Materials
      An external file that holds a picture, illustration, etc.
Object name is canmedaj01027-0005.tif
      Open in a separate window
      An external file that holds a picture, illustration, etc.
Object name is canmedaj01027-0006.tif
      Open in a separate window
      An external file that holds a picture, illustration, etc.
Object name is canmedaj01027-0007.tif
      Open in a separate window
      An external file that holds a picture, illustration, etc.
Object name is canmedaj01027-0008.tif
      Open in a separate window
      An external file that holds a picture, illustration, etc.
Object name is canmedaj01027-0009.tif
      Open in a separate window
      An external file that holds a picture, illustration, etc.
Object name is canmedaj01027-0010.tif
      Open in a separate window

      Articles from Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association


      • Summary
      • |

      • Page Browse
      • |

      • PDF (3.2M)
      • |

      • Citation


      • Share on Facebook
      • Share on Twitter
      • Share on Google Plus

      Support Center
      Support Center

      External link. Please review our privacy policy .

      National Center for
      Biotechnology Information ,
      U.S. National Library of Medicine

      8600 Rockville Pike, Bethesda
      MD, 20894

      Policies and Guidelines | Contact