Fig. 5
Key procedural steps of recipient thoracotomy and native lung exteriorization. (A) Placement of a proximal tracheostomy retraction suture (6 − 0 silk) to enable emergency airway access during lateral positioning; (B) Lateral decubitus positioning and performance of an anterolateral thoracotomy incision guided by the inferior scapular margin; (C) Insertion of a thoracic retractor for optimal exposure of the left hemithorax; (D) Exteriorization of the native left lung with blunt instrumentation, followed by transection of the pulmonary ligament to permit hilar dissection.
