Pre-operative bronchoscopy and mediastinoscopy were both negative. There was no evidence of metastatic spread elsewhere. The patient was positioned in the left lateral decubitus position in preparation for a right posterolateral thoracotomy.
The skin incision was made from midway between scapular tip and spine, curved anteriorly 2 cm below the scapular tip, and extended toward the inframammary fold anteriorly. Selective ventilation was begun to create controlled atelectasis of the right lung.
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