The first step when doing a penumononectomy for cancer of the bronchus is to -
• Pneumonectomy is anatomically more straightforward than lobectomy (in carcinoma bronchus):
• The pulmonary artery is first dissected, divided and sutured.
• The pulmonary veins are then isolated, divided and sutured.
• The main bronchus is divided so that no blind stump remains. The technique of stump closure is important if a bronchopleural fistula is to be avoided. The tissues are carefully handled and the stump is usually stapled.
Ligate the pulmonary vein
Ligate pulmonary artery
Divide the bronchus
Perform lymphnode clearance
Ligate pulmonary artery