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Selection of Intercostal Space during thoracotomy
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Quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth -
"To limit postoperative morbidity, it is desirable and usually possible to employ a muscle-sparing approach, affording adequate exposure yet limiting or avoiding division of the serratus anterior and latissimus dorsi. The scapula is elevated off the chest wall by retractor to gain exposure, and palpation is used to count the ribs to the correct interspace. In most situations in infants, the highest palpable rib is the second. Generally, the fourth interspace is used for a lobectomy, although the fifth also can be used effectively."
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