ABSTRACT
Every general surgeon should have the ability to open the chest of a patient in an emergency. Surgeons working in hospitals without cardiothoracic units, may have to perform an emergency thoracotomy for trauma in a patient who is too severely injured to allow stabilization for transfer to a specialist unit. In addition, the upper gastrointestinal surgeon may require more extensive access to the intrathoracic oesophagus than can be achieved trans-hiatally, while the vascular surgeon may require access to the intrathoracic aorta and its branches. However, in the elective situation, subspecialization has resulted in much of the intrathoracic oesophageal and vascular surgery being transferred to tertiary referral centres.
