Figure 7.

Resection and sternal wedge—part II reconstruction (12). A biologic mesh (XCM Biologic Tissue Matrix™) is sutured to the parietal pleura and to the endothoracic fascia (inferior margin of the resected ribs), ideally reconstructing the endothoracic plane, in order to close the pleural cavity, to prevent lung herniation and possible lung damage through its rubbing/scraping onto the plates. Chest wall reconstruction is then carried out with modelling the precontoured titanium plates to fit the original rib profile (MatrixRIB™ Fixation System), and by locking them with screws onto the ribs and the sternal body, thus granting rigidity, stability of the chest wall and avoiding paradox movements. Especially in large anterior chest wall resections and/or in lean patients, another biological mesh to reconstruct the muscle plain and the fascia over the plates is advisable, as presented in the video. A diamond shaped exeresis of the skin and subcutaneous tissues in the site of FNAB, is highly recommended. Available online: http://www.asvide.com/watch/33048