Pre PACES Podcast #119 REPOST: Lung surgery
Aug 3, 2025
Dr. Aranthakrishnan Raghuram, a consultant respiratory physician and MRCP/PACES chair, shares insights on lung surgery techniques for PACES. He discusses why lung surgery is a frequent topic, the importance of interpreting surgical scars, and key bedside inspection essentials. Raghuram elaborates on recognizing different thoracic scars and emphasizing proper positioning during exams. He also covers the distinctions between lobectomy and pneumonectomy signs, as well as practical tips for auscultation and percussion techniques.
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Find And Describe Surgical Scars
- Inspect the whole chest including posterior and axilla for scars; subtle VATS scars are often lateral.
- If unsure, state the scar and offer a differential rather than overcommitting to a single cause.
Candidate Led Down By A Misread Scar
- Raghuram recounts a candidate who misinterpreted a scar repaired for a skin tumour and went off on a wrong diagnostic path.
- The example warns against forcing findings to an attractive but incorrect diagnosis.
Palpate Chest Expansion Correctly
- Start palpation at end-expiration with thumbs opposed and watch chest expansion carefully.
- Perform expansion posteriorly for a second check and avoid false negatives for lobectomies.