Hemiclamshell approach for left pneumonectomy.

Hemiclamshell and clamshell incisions were virtually forgotten since the introduction to cardiac surgery of median sternotomy and the exhilarating advances in minimally invasive thoracic surgery. However, in rare clinical scenarios, as in large, space-occupying lesions in thoracic cavity, the surgeon will resort to a clamshell or a hemiclamshell approach to achieve complete exposure and remove a large mass from the thoracic cavity. In this video tutorial, we demonstrate the operative steps of the hemiclamshell approach in a clinical scenario for a left pneumonectomy for T4N1M0 non-small-cell lung cancer.