Learn how to perform an emergency thoracotomy rapidly and safely in a trauma patient

Clamshell thoracotomy (also known as bilateral anterior thoracotomy) is a technique used to provide complete exposure of the thoracic cavity. What are the risks of performing this procedure and how can they be minimized?

Review our new Clamshell Thoracotomy procedure now available on the Touch Surgery app to learn how our key opinion leader Dr Morgan Mcmonagle (Trauma and Vascular Surgeon) provides step-by-step details of this procedure.

Key facts:

  • Thoracic trauma accounts for > 25% of all traumatic injuries and is a leading cause of death in all age groups.
  • Studies have demonstrated that it is easier to control the cardiac wound using this approach compared to the standard left anterolateral thoracotomy

Dr. Morgan Mcmonagle describes how to avoid delays in performing an emergency thoracotomy:

“Due to time constraints, DO NOT count the ribs of the patient. Use the outer aspect of the patient’s pectoralis major muscles (in men) or the breast tissue (in women) as a landmark for the 5th intercostal space”

Understand why it is important to detect and ligate the internal mammary artery.

emergency thoracotomy
Detection and ligation of the internal mammary artery following clamshell thoracotomy

Learn how to avoid occlusions to the coronary arteries if a cardiac wound is adjacent and what to do if the heart goes into ventricular fibrillation during the procedure.

“If the wound is very close to a coronary artery,  suture deep and behind the vessel…it may be reinforced using pledgeted sutures.”

Suturing a cardiac wound
Suturing a cardiac wound


View our new simulation – Clamshell Thoracotomy – on the Touch Surgery App and test your procedural awareness.